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Improving the Endoscopic Detection Rate in Patients with Early Gastric Cancer.

Moon HS - Clin Endosc (2015)

Bottom Line: Endoscopists should ideally possess both sufficient knowledge of the endoscopic gastrointestinal disease findings and an appropriate attitude.Before performing endoscopy, the endoscopist must identify several risk factors of gastric cancer, including the patient's age, comorbidities, and drug history, a family history of gastric cancer, previous endoscopic findings of atrophic gastritis or intestinal metaplasia, and a history of previous endoscopic treatments.During endoscopic examination, the macroscopic appearance is very important for the diagnosis of early gastric cancer; therefore, the endoscopist should have a consistent and organized endoscope processing technique and the ability to comprehensively investigate the entire stomach, even blind spots.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.

ABSTRACT
Endoscopists should ideally possess both sufficient knowledge of the endoscopic gastrointestinal disease findings and an appropriate attitude. Before performing endoscopy, the endoscopist must identify several risk factors of gastric cancer, including the patient's age, comorbidities, and drug history, a family history of gastric cancer, previous endoscopic findings of atrophic gastritis or intestinal metaplasia, and a history of previous endoscopic treatments. During endoscopic examination, the macroscopic appearance is very important for the diagnosis of early gastric cancer; therefore, the endoscopist should have a consistent and organized endoscope processing technique and the ability to comprehensively investigate the entire stomach, even blind spots.

No MeSH data available.


Related in: MedlinePlus

Endoscopic findings of early gastric cancer (EGC) lesions. (A) A whitish, elevated flat lesion (EGC 0-IIa) shown at an angle. (B) A doughnut-like elevated lesion (EGC 0-IIc) in the lesser curvature of the lower body. (C) A reddish depression (EGC 0-IIc) in the lesser curvature of the antrum. (D) Reddish mucosal changes (EGC 0-IIb) in the angle. (E) Whitish mucosa changes (EGC 0-IIb) in the angle. (F) Granular mucosal changes (EGC 0-IIb) in the greater curvature of the lower body.
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Figure 2: Endoscopic findings of early gastric cancer (EGC) lesions. (A) A whitish, elevated flat lesion (EGC 0-IIa) shown at an angle. (B) A doughnut-like elevated lesion (EGC 0-IIc) in the lesser curvature of the lower body. (C) A reddish depression (EGC 0-IIc) in the lesser curvature of the antrum. (D) Reddish mucosal changes (EGC 0-IIb) in the angle. (E) Whitish mucosa changes (EGC 0-IIb) in the angle. (F) Granular mucosal changes (EGC 0-IIb) in the greater curvature of the lower body.

Mentions: The newest endoscopic technologies of magnification endoscopy and narrow band imaging (NBI) endoscopy, which comprise image-enhanced endoscopy, are very helpful for characterizing gastrointestinal lesions; however, white light endoscopy remains the core endoscopic technology for detecting EGC.14 EGC has various morphologies, from subtle mucosal surface changes to color changes (Fig. 2). According to recently reported endoscopic findings in Korea, of 1,942 patients, 306 (16.6%) were diagnosed with elevated-type EGC, 528 (28.6%) with flat-type EGC, and 1,011 (54.8%) with depressed-type EGC. Intestinal-type EGC and well/moderately differentiated lesions were macroscopically observed as elevated-type EGC, while signet ring cells and poorly differentiated lesions were observed as relatively flat and depressed types (p<0.001).15 Protruded (0-I) and excavated (0-III) types are fairly easily diagnosed by endoscopic examination, whereas superficial (0-II) types are not since some superficial types of cancer resemble gastritis.16


Improving the Endoscopic Detection Rate in Patients with Early Gastric Cancer.

Moon HS - Clin Endosc (2015)

Endoscopic findings of early gastric cancer (EGC) lesions. (A) A whitish, elevated flat lesion (EGC 0-IIa) shown at an angle. (B) A doughnut-like elevated lesion (EGC 0-IIc) in the lesser curvature of the lower body. (C) A reddish depression (EGC 0-IIc) in the lesser curvature of the antrum. (D) Reddish mucosal changes (EGC 0-IIb) in the angle. (E) Whitish mucosa changes (EGC 0-IIb) in the angle. (F) Granular mucosal changes (EGC 0-IIb) in the greater curvature of the lower body.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4522419&req=5

Figure 2: Endoscopic findings of early gastric cancer (EGC) lesions. (A) A whitish, elevated flat lesion (EGC 0-IIa) shown at an angle. (B) A doughnut-like elevated lesion (EGC 0-IIc) in the lesser curvature of the lower body. (C) A reddish depression (EGC 0-IIc) in the lesser curvature of the antrum. (D) Reddish mucosal changes (EGC 0-IIb) in the angle. (E) Whitish mucosa changes (EGC 0-IIb) in the angle. (F) Granular mucosal changes (EGC 0-IIb) in the greater curvature of the lower body.
Mentions: The newest endoscopic technologies of magnification endoscopy and narrow band imaging (NBI) endoscopy, which comprise image-enhanced endoscopy, are very helpful for characterizing gastrointestinal lesions; however, white light endoscopy remains the core endoscopic technology for detecting EGC.14 EGC has various morphologies, from subtle mucosal surface changes to color changes (Fig. 2). According to recently reported endoscopic findings in Korea, of 1,942 patients, 306 (16.6%) were diagnosed with elevated-type EGC, 528 (28.6%) with flat-type EGC, and 1,011 (54.8%) with depressed-type EGC. Intestinal-type EGC and well/moderately differentiated lesions were macroscopically observed as elevated-type EGC, while signet ring cells and poorly differentiated lesions were observed as relatively flat and depressed types (p<0.001).15 Protruded (0-I) and excavated (0-III) types are fairly easily diagnosed by endoscopic examination, whereas superficial (0-II) types are not since some superficial types of cancer resemble gastritis.16

Bottom Line: Endoscopists should ideally possess both sufficient knowledge of the endoscopic gastrointestinal disease findings and an appropriate attitude.Before performing endoscopy, the endoscopist must identify several risk factors of gastric cancer, including the patient's age, comorbidities, and drug history, a family history of gastric cancer, previous endoscopic findings of atrophic gastritis or intestinal metaplasia, and a history of previous endoscopic treatments.During endoscopic examination, the macroscopic appearance is very important for the diagnosis of early gastric cancer; therefore, the endoscopist should have a consistent and organized endoscope processing technique and the ability to comprehensively investigate the entire stomach, even blind spots.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.

ABSTRACT
Endoscopists should ideally possess both sufficient knowledge of the endoscopic gastrointestinal disease findings and an appropriate attitude. Before performing endoscopy, the endoscopist must identify several risk factors of gastric cancer, including the patient's age, comorbidities, and drug history, a family history of gastric cancer, previous endoscopic findings of atrophic gastritis or intestinal metaplasia, and a history of previous endoscopic treatments. During endoscopic examination, the macroscopic appearance is very important for the diagnosis of early gastric cancer; therefore, the endoscopist should have a consistent and organized endoscope processing technique and the ability to comprehensively investigate the entire stomach, even blind spots.

No MeSH data available.


Related in: MedlinePlus