Early gastric cancer diagnostic ability of ultrathin endoscope loaded with laser light source

Abstract

Background: Conventionally, the low luminous intensity, low image resolution, and difficulty in operation have been reported with the ultrathin endoscope. However, it has markedly advanced recently. The improvement of the diagnostic ability is expected.

Aim: To compare the early gastric cancer diagnostic ability of an ultrathin endoscope loaded with a laser light source and that of the conventional endoscope.

Methods: The target subjects were 375 consecutive patients who underwent endoscopy at our hospital for post-endoscopic submucosal dissection follow-up of gastric cancer from January to August 2018. During endoscopy, the ultrathin endoscope was used in 140 patients (37.3%), and the conventional endoscope was used in 235 patients (62.7%). Patient background was adjusted using the propensity score matching method, and gastric cancer detection ability was evaluated in the two groups.

Results: The gastric cancer detection rate was 7.8% in the ultrathin endoscope group and 7.0% in the conventional endoscope group, and the mean intragastric observation time was 4.1 ± 1.7 min in the ultrathin endoscope group and 4.1 ± 1.9 min in the conventional endoscope group, showing no significant differences between the groups. Moreover, the biopsy implementation rate was 31.8% in the ultrathin endoscope group and 41.1% in the conventional endoscope group, and the biopsy prediction rate was 17.9% and 13.2%, respectively, showing no significant differences between the groups.

Conclusion: The gastric cancer diagnostic ability of the ultrathin endoscope loaded with a laser light source was comparable to that of the conventional endoscope. The observation time was also comparable. Thus, endoscopy using the ultrathin endoscope loaded with the laser light source would be the first option in screening examinations of gastric cancer due to its low invasion.

Keywords: Conventional endoscope; Gastric cancer; Laser light source; Screening; Ultrathin endoscope.

Figure 1

A patient with gastric cancer detected through the ultrathin endoscope. IIa lesion in the vicinity of previous endoscopic submucosal dissection scar on the anterior wall of the antrum. Results of endoscopic submucosal dissection: 10 mm × 10 mm, tubular adenocarcinoma, well-differentiated type, pT1a (M).

Figure 2

A patient with gastric cancer detected through the conventional endoscope. Endoscopic submucosal dissection scar on the anterior wall of the antrum and IIc lesion on the posterior wall. Results of endoscopic submucosal dissection: 5 mm × 5 mm, tubular adenocarcinoma, well-differentiated type, pT1a (M).