UPDATE ON THE DIAGNOSIS AND MANAGEMENT OF EARLY GASTRIC CANCER

2015 ◽  
pp. 5-14
Author(s):  
Van Huy Tran ◽  
Quang Trung Tran

The prognosis of gastric cancer depends principally upon an early diagnosis. An early and accurate diagnosis of gastric cancer needs some basic knowledges about the endoscopic characteristics of white light endoscopy, chromoendoscopy, magnified endoscopy, FICE and NBI…A strategy of screening is also a key factor for early diagnosis. The treatment of early gastric cancer by endoscopy techniques have showed more and more advantages. Beside of EMR, the technique of ESD is now applied more widely and lead to a very good prognosis and nearly a curative treatment for the patients with early gastric cancer. Key words: gastric cancer, early gastric cancer, diagnosis, endoscopy

Endoscopy ◽  
2021 ◽  
Author(s):  
Diogo Libânio ◽  
Jessica Rocha Rodrigues ◽  
Maria Jose Bento ◽  
Alanna Ebigbo ◽  
Helmut Messmann ◽  
...  

Background/aims: Increased awareness of gastric cancer risk, easy access to upper endoscopy, high-definition endoscopes with virtual chromoendoscopy may have led to an increase in early gastric cancer diagnosis within the last years in Europe. Early diagnosis of gastric cancer may be associated with improved survival. Currently, no data exist on the impact of early diagnosis in gastric cancer patients’ survival at a population level in Europe. Our aim was to assess incidence, early diagnosis rate and gastric cancer survival both in North-Western and Southern European countries with a low to moderate GC incidence. Methods: Data on 41,138 gastric cancer cases between 2007 and 2016 were retrieved from national cancer registries of Belgium, the Netherlands and the Northern Region in Portugal (RORENO). Age standardized incidence and mortality rates (ASMR) were assessed and expressed by 100,000 persons. Early diagnosis was defined as T1 staged tumors (TNM staging). Net survival estimates for 2007-2011 vs 2012-2016 were determined and compared. Results: Age-standardized incidence and mortality decreased over time in Belgium, Northern Portugal and the Netherlands. Early gastric cancer diagnosis increased over time for all the countries. Net 1- year survival improved significantly between the two time periods in all countries and at 5 years in Belgium and Portugal. Conclusions: This is the first study comparing trends in gastric cancer incidence and mortality in some European countries. We found from 2007-2016 a trend towards a rising proportion of T1 gastric cancers and a decrease in ASMR over time, supporting the efforts in secondary prevention strategies.


2020 ◽  
Author(s):  
Xin Ge ◽  
Xiaolei Zhang ◽  
Yanling Ma ◽  
Shaohua Chen ◽  
Zhaowu Chen ◽  
...  

Abstract BACKGROUND Early diagnosis is very important to improve the survival rate of patients with gastric cancer, especially in asymptomatic participants. However, low sensitivity of common biomarkers has caused difficulties in early screening of gastric cancer. In this study, we explored whether MIC-1 can improve the detection rate of early gastric cancer.METHODS We screened 8,257 participants based on risk factors such as age, gender, and family history for physical examination including gastroscopy. Participant blood samples were taken for measure MIC-1, CA-199, CA72-4 and PG1/PG2 levels. The diagnostic performance of MIC-1 was assessed and compared with CA-199, CA72-4 and PG1/PG2, and its role in early gastric cancer diagnosis and the assessment of the risk of precancerous lesions have also been studied.RESULTS Based on endoscopic and histopathological findings, 55 participants had gastric cancer, 566 participants had low-grade neoplasia, 2605 participants had chronic gastritis. MIC-1 levels were significantly elevated in gastric cancer serum samples as compared to controls (p<0.001). The sensitivity of serum MIC-1 for gastric cancer diagnosis was much higher than that of CA-199 (49.1% vs. 20.0%) with similar specificities. Moreover, receiver operating characteristic (ROC) curve analysis also showed that serum MIC-1 had a better performance compared with CA-199, CA72-4 and PG1/PG2 in distinguishing early-stage gastric cancer (AUC: 72.9% vs. 69.5%, 67.5%, 44.0% respectively).CONCLUSIONS Serum MIC-1 is significantly elevated in most patients with early gastric cancer. MIC-1 can serve as a novel diagnostic marker of early gastric cancer and value the risk of gastric cancer.


2020 ◽  
Vol 91 (6) ◽  
pp. AB593
Author(s):  
Kiki Fockens ◽  
Maarten Struyvenberg ◽  
Jeroen de Groof ◽  
Tsevelnorov Khurelbaatar ◽  
Nahid Mostafavi ◽  
...  

2017 ◽  
Vol 17 (1) ◽  
Author(s):  
Lianjun Di ◽  
Huichao Wu ◽  
Rong Zhu ◽  
Youfeng Li ◽  
Xinglong Wu ◽  
...  

Author(s):  
Nhật Tân Phan

TO EVALUATE THE DIAGNOSIS AND TREATMENT OF EARLY GASTRIC CANCER AT HUE CENTRAL HOSPITAL Objectiva: to evaluate the diagnosis and treatment of early gastric cancer at Hue Central Hospital. Material and methods: A retrospective study on patients with suspected lesions on white light endoscopy were performed magnifying endoscopy at Hue Central Hospital from January 2017 to December 2018. Patients who were diagnosed with early cancer will be removed with ESD treatment if indicated and surveiled after 06 months of treatment. Results: We collected and analyzed data from 104 endoscopic patients who screening for early cancer by magnifying endoscopy, 24 patients were diagnosed with early cancer, 15 men, 9 women;12 patients were treated with the Endoscopic Submucosal Dissection (ESD) method from January 2017 to December 2018. There are no specific symptoms for early stomach cancer. Superficial depressed-type (0-IIc) and Differentiated type account for the highest proportion. The patients in the study were treated with ESD, had a hemorrhage patient in the procedure and had to intervene with Coagrasper Hemostatic Forceps, without perforation complications during and after the procedure. The Diagnosis before and after treatment is consistent. During follow-up, no patients were found to have recurrence or distant metastasis. Conclusion: Early gastric cancer can still be treated well with endoscopic techniques. Multi-disciplinary coordination is needed to develop early diagnosis and treatment of cancer. Keywords: early gastric cancer, Endoscopic submucosal dissection (ESD)


2019 ◽  
Vol 07 (08) ◽  
pp. E1002-E1007 ◽  
Author(s):  
Mary Raina Angeli Abad ◽  
Haruhiro Inoue ◽  
Haruo Ikeda ◽  
Anastassios Manolakis ◽  
Enrique Rodriguez de Santiago ◽  
...  

Abstract Background and study aims Fourth-generation endocytoscopy is an ultra-high magnification endoscopic technique designed to provide excellent quality in vivo histologic assessment of gastrointestinal lesions. This study aims to evaluate the diagnostic accuracy of endocytoscopy in early gastric cancer diagnosis. Patients and methods A single-center, retrospective analysis of prospectively collected data from all gastric endocytoscopic examinations was conducted. Two expert endoscopists, blinded to white-light and narrow-band imaging findings as well as histopathologic diagnosis, independently reviewed and diagnosed all endocytoscopic images. A newly recognized “enlarged nuclear sign” was detected, and its implication in early gastric cancer diagnosis was evaluated. The diagnostic performance of fourth-generation endocytoscopy was assessed while using the gold standard histopathology as a reference. Results Forty-three patients (mean age±SD, 72.6 ± 12.1 years; 31 males) were enrolled. Based on histopathology, 23 had well-differentiated adenocarcinomas, four adenomas, and 16 non-neoplastic lesions. The sensitivity, specificity, and accuracy of fourth-generation endocytoscopy for gastric cancer diagnosis were 87.0 % (95 % CI: 67.9 – 95.5), 80.0 % (95 % CI: 58.4 – 91.9), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist A; and 91.3 % (95 % CI: 73.2 – 97.6), 75.0 % (95 % CI: 53.1 – 88.8), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist B. The inter-observer agreement, Kappa statistic = 0.71 (95 % CI: 0.50 – 0.93), was good. The sensitivity, specificity, and accuracy of the enlarged nuclear sign for early gastric cancer diagnosis were 87.0 % (95 % CI: 67.9 – 95.5), 95.0 % (95 % CI: 76.4 – 99.1), and 90.7 % (95 % CI: 78.4 – 96.3) by endoscopist A; and 82.6 % (95 % CI: 62.9 – 93.0), 85.0 % (95 % CI: 64.0 – 94.8), and 83.7 % (95 % CI: 70.0 – 91.9) by endoscopist B. The inter-observer agreement, Kappa statistic = 0.68 (95 % CI: 0.51 – 0.89) was good. Conclusion: Fourth-generation endocytoscopy appears to aid in the diagnosis of early gastric cancer, particularly well-differentiated adenocarcinomas, due to its good diagnostic accuracy and identification of the “enlarged nuclear sign,” and deserves further evaluation in future studies.


2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 29-29 ◽  
Author(s):  
T. Bouca-Machado ◽  
H. Santos Sousa ◽  
E. Lima-da-costa ◽  
J. Pinto-de-Sousa ◽  
J. Preto ◽  
...  

29 Background: The aim of this study was to evaluate the characteristics of early gastric cancer (EGC) in comparison to advanced tumors and its role in patient's prognosis. Methods: This study was related to 1,272 patients admitted with gastric or gastroesophageal junction carcinoma in our department, between January 1988 and December 2008. During this period the incidence of EGC was 12.68% (3.62% T0, 42.75% T1a and 53.62% T1b). Several clinical, pathological and staging parameters were evaluated according to classification in EGC and advanced tumors. Results: Significant differences were observed in location (p<0.001); type of resection surgery (p<0.001) and of lymphadenectomy (p=0.008 for Siewert and p<0.001 for Japanese classifications) with less radical surgery in EGC patients. This type of tumors presented characteristics associated with a better prognosis in the following pathological parameters: tumor dimensions (p<0.001), macroscopic form (p<0.001), Ming's classification (p<0.001), venous invasion (p<0.001) and lymphatic permeation (p<0.001). The 5-year survival rate of this series was 33.7%. There were significant differences in survival curves according to classification in EGC and advanced tumors (73% at 5 years and 26% at 5 years, respectively). Cox-regression analysis identified age, T and lymph node ratio as independent prognostic factors. There was no significant differences in age (cut-off 45 years), but there was significant differences in lymph node metastasis (p<0.001). In 23.87% of EGC there was lymph node involvement, with significant differences (p=0.002) according to the depth wall invasion [T0 (100% N0), T1a (91.5% N0, 8.5% N1), T1b (60.8% N0, 21.6% N1, 13.5% N2, 4.1% N3a)]. Conclusions: The EGC percentage in our series was lower in comparison with other countries with high incidence of gastric cancer. The prognosis of the patients with gastric carcinoma continues to be gloomy mainly due to the late diagnosis and, given that the surgical treatment doesn't seem plausible of achieving a margin of significant additional progression, the need for an early diagnosis emerges if an improvement in patient survival is desired. No significant financial relationships to disclose.


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