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Review
. 2022 Jul 22:12:855216.
doi: 10.3389/fonc.2022.855216. eCollection 2022.

Detection and Characterization of Early Gastric Cancer

Carlos Noronha Ferreira  1   2 , Juliana Serrazina  1 , Rui Tato Marinho  1   2
Affiliations
Review

Detection and Characterization of Early Gastric Cancer

Carlos Noronha Ferreira et al. Front Oncol. .

Abstract

In this review, we would like to focus on risk stratification and quality indicators of diagnostic upper gastrointestinal endoscopy in the detection and characterization of early gastric cancer. Preparation of the upper gastrointestinal tract with mucolytic agents or simethicone is often overlooked in the west, and this inexpensive step prior to endoscopy can greatly improve the quality of imaging of the upper digestive tract. Risk stratification based on epidemiological features including family history, Helicobacter pylori infection status, and tobacco smoking is often overlooked but may be useful to identify a subgroup of patients at higher risk of developing gastric cancer. Quality indicators of diagnostic upper gastrointestinal endoscopy are now well defined and include: minimal inspection time of 3 min, adequate photographic documentation of upper gastrointestinal landmarks, utilization of advanced endoscopic imaging technology including narrow band imaging and blue laser imaging to detect intestinal metaplasia and characterize early gastric cancer; and standardized biopsy protocols allow for histological evaluation of gastric mucosa and detection of atrophic gastritis and intestinal metaplasia. Finally, endoscopic and histologic classifications such as the Kimura-Takemoto Classification of atrophic gastritis and the OLGA-OLGIM classifications may help stratify patients at a higher risk of developing early gastric cancer.

Keywords: advanced endoscopic imaging; early gastric cancer; quality indicators; risk stratification; upper gastrointestinal endoscopy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kimura-Takemoto classification of endoscopic gastric mucosal atrophy. Reproduced with permission of the publishers from (1)
Figure 2
Figure 2
Diagnostic algorithm for gastric cancer with magnifying endoscopy. Reproduced with permission from Yao K et al. (1)
Figure 3
Figure 3
Demarcation line (yellow arrows) and irregular microvascular pattern (blue arrows) suggesting early gastric cancer. Reproduced with permission from Muto M et al. (19)
See this image and copyright information in PMC

References

    1. Yao K, Uedo N, Kamada T, Hirasawa T, Nagahama T, Yoshinaga S, et al. . Guidelines for Endoscopic Diagnosis of Early Gastric Cancer. Dig Endosc (2020), 32(5):663–98. doi: 10.1111/den.13684 - DOI - PubMed
    1. Pimentel-Nunes P, Libânio D, Marcos-Pinto R, Areia M, Leja M, Esposito G, et al. . Management of Epithelial Precancerous Conditions and Lesions in the Stomach (MAPS II): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG), European Society of Pathology (ESP), and Sociedade Portuguesa De Endoscopia Digestiva (SPED) Guideline Update 2019. Endoscopy (2019) 51:365–88. doi: 10.1055/a-0859-1883 - DOI - PubMed
    1. Masuyama H, Yoshitake N, Sasai T, Nakamura T, Masuyama A, Zuiki T, et al. . Relationship Between the Degree of Endoscopic Atrophy of the Gastric Mucosa and Carcinogenic Risk. Digestion (2015) 91:30–6. doi: 10.1159/000368807 - DOI - PMC - PubMed
    1. Uemura N, Okamoto S, Yamamoto S, Matsumura N, Yamaguchi S, Yamakido M, et al. . Helicobacter Pylori Infection and the Development of Gastric Cancer. N Engl J Med (2001) 345(11):784–9. doi: 10.1056/NEJMoa001999 - DOI - PubMed
    1. Arnold M, Abnet CC, Neale RE, Vignat J, Giovannucci EL, McGlynn KA, et al. . Global Burden of 5 Major Types of Gastrointestinal Cancer. Gastroenterology (2020) 159:335–349.e15. doi: 10.1053/j.gastro.2020.02.068 - DOI - PMC - PubMed

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