Clin Endosc.  2015 Jul;48(4):291-296. 10.5946/ce.2015.48.4.291.

Improving the Endoscopic Detection Rate in Patients with Early Gastric Cancer

• Moon HS

• KMID: 1964270
• DOI: http://doi.org/10.5946/ce.2015.48.4.291

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.

Keyword

Endoscopy; Early gastric cancer; Detection

MeSH Terms

Comorbidity
Diagnosis
Endoscopes
Endoscopy
Gastritis, Atrophic
Gastrointestinal Diseases
Humans
Metaplasia
Optic Disk
Risk Factors
Stomach
Stomach Neoplasms*

Figure

• 

  Fig. 1 Endoscopic findings of various early gastric cancer (EGC) lesions in the blind spot areas. (A) A flat erythematous lesion (EGC 0-IIb) at the cardia. (B) An irregular flat lesion (EGC 0-IIb) in the posterior wall of the upper body. (C) A disrupted mucosal fold (EGC 0-IIc) in the greater curvature of the upper body. (D) A discolored flat lesion (EGC 0-IIb) in the posterior wall of the lower body. (E) A reddish flat lesion (EGC 0-IIb) in the P-ring. (F) A well-demarcated depressed lesion (EGC 0-IIc) in the lesser curvature of the antrum.

• 

  Fig. 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.

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  Fig. 3 Endoscopic finding of the depressed lesion type in early gastric cancer.

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  Fig. 4 Endoscopic findings. (A) A mucosal convergence is noted, but no elevation at the tip of the converging folds is seen, and the depth of invasion is thus diagnosed as limited to the mucosa. (B) Remarkable elevation of the tumor is seen with a converging fold. These findings fulfill the criteria for massive submucosal invasion by cancer.

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  Fig. 5 Endoscopic finding of the flat lesion type in early gastric cancer (A, B).

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