Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer
Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti-<i>H. pylori</i> IgG antibody values is very promising. After the detection of suspic...
| Main Author: | |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2024-03-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/16/5/1039 |
| _version_ | 1797264723234783232 |
|---|---|
| author | Mitsuhiro Fujishiro |
| author_facet | Mitsuhiro Fujishiro |
| author_sort | Mitsuhiro Fujishiro |
| collection | DOAJ |
| description | Endoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti-<i>H. pylori</i> IgG antibody values is very promising. After the detection of suspicious lesions of EGC, a detailed observation using magnifying endoscopy with band-limited light is necessary, which reveals an irregular microsurface and/or an irregular microvascular pattern with demarcation lines in the case of cancerous lesions. Endocytoscopy enables us to make an in vivo histological diagnosis. In terms of the indications for endoscopic resection, the likelihood of lymph node metastasis and technical difficulties in en bloc resection is considered, and they are divided into absolute, expanded, and relative indications. Endoscopic mucosal resection and endoscopic submucosal dissection are the main treatment modalities nowadays. After endoscopic resection, curability is evaluated histologically as endoscopic curability (eCura) A, B, and C (C-1 and C-2). Recent evidence suggests that the outcomes of endoscopic resection for many EGCs are comparable to those of gastrectomy and that endoscopic resection is the gold standard for node-negative early gastric cancers. Personalized medicine is also being developed to overcome the unmet needs in treatments of EGC, for example the further expansion of indications and newer resection techniques, such as full-thickness resection. |
| first_indexed | 2024-04-25T00:33:26Z |
| format | Article |
| id | doaj.art-7f5611bb33bb4075846a97e661a57165 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-04-25T00:33:26Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-7f5611bb33bb4075846a97e661a571652024-03-12T16:41:17ZengMDPI AGCancers2072-66942024-03-01165103910.3390/cancers16051039Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric CancerMitsuhiro Fujishiro0Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-8655, JapanEndoscopy is mandatory to detect early gastric cancer (EGC). When considering the cost-effectiveness of the endoscopic screening of EGC, risk stratification by combining serum pepsinogen values and anti-<i>H. pylori</i> IgG antibody values is very promising. After the detection of suspicious lesions of EGC, a detailed observation using magnifying endoscopy with band-limited light is necessary, which reveals an irregular microsurface and/or an irregular microvascular pattern with demarcation lines in the case of cancerous lesions. Endocytoscopy enables us to make an in vivo histological diagnosis. In terms of the indications for endoscopic resection, the likelihood of lymph node metastasis and technical difficulties in en bloc resection is considered, and they are divided into absolute, expanded, and relative indications. Endoscopic mucosal resection and endoscopic submucosal dissection are the main treatment modalities nowadays. After endoscopic resection, curability is evaluated histologically as endoscopic curability (eCura) A, B, and C (C-1 and C-2). Recent evidence suggests that the outcomes of endoscopic resection for many EGCs are comparable to those of gastrectomy and that endoscopic resection is the gold standard for node-negative early gastric cancers. Personalized medicine is also being developed to overcome the unmet needs in treatments of EGC, for example the further expansion of indications and newer resection techniques, such as full-thickness resection.https://www.mdpi.com/2072-6694/16/5/1039early gastric cancergastric cancer screeningendoscopic diagnosisendoscopic mucosal resectionendoscopic submucosal dissection |
| spellingShingle | Mitsuhiro Fujishiro Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer Cancers early gastric cancer gastric cancer screening endoscopic diagnosis endoscopic mucosal resection endoscopic submucosal dissection |
| title | Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer |
| title_full | Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer |
| title_fullStr | Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer |
| title_full_unstemmed | Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer |
| title_short | Advanced Diagnostic and Therapeutic Endoscopy for Early Gastric Cancer |
| title_sort | advanced diagnostic and therapeutic endoscopy for early gastric cancer |
| topic | early gastric cancer gastric cancer screening endoscopic diagnosis endoscopic mucosal resection endoscopic submucosal dissection |
| url | https://www.mdpi.com/2072-6694/16/5/1039 |
| work_keys_str_mv | AT mitsuhirofujishiro advanceddiagnosticandtherapeuticendoscopyforearlygastriccancer |