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Life sciences · Journal article
Den Open · September 23, 2026
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Objectives. To investigate early changes in gastric cancers that are difficult to evaluate using endoscopic imaging through the assessment of mucosal impedance (MI) in endoscopic submucosal dissection (ESD) specimens.Methods. In this single-center prospective cohort study, we included patients who underwent ESD for early gastric cancer (EGC). MI was measured at both the main tumor site and the surrounding non-neoplastic mucosa in resected specimens. Histopathological evaluation and immunohistochemical staining for claudin-3, -4, and -18 were performed. Furthermore, multivariate analysis was used to investigate factors influencing MI-L.Results. The MI measured under high-frequency current (MI-H) of the non-neoplastic mucosa was significantly higher than that of the tumor (p = 0.0025). Additionally, the MI measured under low-frequency current (MI-L) was significantly lower in pT1b cases than in pT1a cases (6.9 Ω vs. 9.7 Ω, p = 0.021). Similarly, the MI-L was significantly lower in the pUL1 cases than in the pUL0 cases (7.5 Ω vs. 9.7 Ω, p = 0.030). Multivariable linear regression analysis demonstrated that, among the explanatory variables-including tumor invasion, ulcer status, macroscopic type, and the H-scores for each claudin- only the H-score of claudin-18 was identified as an independent associated factor.Conclusions. In resected specimens, MI-L was independently associated with claudin-18 expression and correlated with submucosal invasion, ulcer status, and macroscopic type. MI has the potential to detect non-surface changes involving tight junction proteins in EGC that cannot be observed via endoscopy.Trial Registration: N/A.