scholarly journals Advances in the Aetiology & Endoscopic Detection and Management of Early Gastric Cancer

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6242
Author(s):  
Darina Kohoutova ◽  
Matthew Banks ◽  
Jan Bures
Keyword(s):  
Gastric Cancer ◽  
Helicobacter Pylori ◽  
Gastric Carcinoma ◽  
Intestinal Metaplasia ◽  
Precancerous Lesions ◽  
Gastric Atrophy ◽  
High Definition ◽  
Gastric Intestinal Metaplasia ◽  
White Light Endoscopy ◽  
Magnification Endoscopy

The mortality rates of gastric carcinoma remain high, despite the progress in research and development in disease mechanisms and treatment. Therefore, recognition of gastric precancerous lesions and early neoplasia is crucial. Two subtypes of sporadic gastric cancer have been recognized: cardia subtype and non-cardia (distal) subtype, the latter being more frequent and largely associated with infection of Helicobacter pylori, a class I carcinogen. Helicobacter pylori initiates the widely accepted Correa cascade, describing a stepwise progression through precursor lesions from chronic inflammation to gastric atrophy, gastric intestinal metaplasia and neoplasia. Our knowledge on He-licobacter pylori is still limited, and multiple questions in the context of its contribution to the pathogenesis of gastric neoplasia are yet to be answered. Awareness and recognition of gastric atrophy and intestinal metaplasia on high-definition white-light endoscopy, image-enhanced endoscopy and magnification endoscopy, in combination with histology from the biopsies taken accurately according to the protocol, are crucial to guiding the management. Standard indications for endoscopic resections (endoscopic mucosal resection and endoscopic submucosal dissection) of gastric dysplasia and intestinal type of gastric carcinoma have been recommended by multiple societies. Endoscopic evaluation and surveillance should be offered to individuals with an inherited predisposition to gastric carcinoma.

Computed Tomography Findings in Gastric Intestinal Metaplasia

2019 ◽  
pp. 1-4
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Early Diagnosis ◽  
Intestinal Metaplasia ◽  
Large Scale ◽  
Precancerous Lesions ◽  
Precancerous Lesion ◽  
Endoscopic Examination ◽  
Cancer Risk Factors ◽  
Gastric Intestinal Metaplasia

Because the prevalence of gastric cancer is high and its prognosis is poor in the general population, early diagnosis is important. For gastric cancer, risk factors and precancerous lesions are well known. For gastric cancer, computed tomography has an important role in diagnosis, staging and treatment planning. When we look at the literature for the diagnosis of precancerous lesion, which will be an early diagnosis guide, we did not find any information about imaging findings. Gastric intestinal metaplasia was a precancerous lesion and we retrospectively analyzed the computed tomography sections of three patients who underwent endoscopic examination. In the pathological specimen, we noticed that the intestinal metaplasia, gastric mucosal rachas, lasagna-like, lace-style, parallel to each other showed a rough coincidence. We believe that large-scale, prospective studies will increase the incidence of gastric intestinal metaplasia, a precancerous lesion, and contribute to the early diagnosis of gastric cancer.

scholarly journals Recent advances in the detection and management of early gastric cancer and its precursors

2020 ◽  
pp. flgastro-2018-101089 ◽  
Author(s):  
William Waddingham ◽  
Stella A V Nieuwenburg ◽  
Sean Carlson ◽  
Manuel Rodriguez-Justo ◽  
Manon Spaander ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Risk ◽  
Early Gastric Cancer ◽  
Endoscopic Resection ◽  
Treatment Options ◽  
Survival Rates ◽  
Premalignant Lesions ◽  
High Definition ◽  
Gastric Intestinal Metaplasia ◽  
White Light Endoscopy

Despite declines in incidence, gastric cancer remains a disease with a poor prognosis and limited treatment options due to its often late stage of diagnosis. In contrast, early gastric cancer has a good to excellent prognosis, with 5-year survival rates as high as 92.6% after endoscopic resection. There remains an East-West divide for this disease, with high incidence countries such as Japan seeing earlier diagnoses and reduced mortality, in part thanks to the success of a national screening programme. With missed cancers still prevalent at upper endoscopy in the West, and variable approaches to assessment of the high-risk stomach, the quality of endoscopy we provide must be a focus for improvement, with particular attention paid to the minority of patients at increased cancer risk. High-definition endoscopy with virtual chromoendoscopy is superior to white light endoscopy alone. These enhanced imaging modalities allow the experienced endoscopist to accurately and robustly detect high-risk lesions in the stomach. An endoscopy-led staging strategy would mean biopsies could be targeted to histologically confirm the endoscopic impression of premalignant lesions including atrophic gastritis, gastric intestinal metaplasia, dysplasia and early cancer. This approach to quality improvement will reduce missed diagnoses and, combined with the latest endoscopic resection techniques performed at expert centres, will improve early detection and ultimately patient outcomes. In this review, we outline the latest evidence relating to diagnosis, staging and treatment of early gastric cancer and its precursor lesions.

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