Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 1;35(3):285-287.
doi: 10.1097/MEG.0000000000002513. Epub 2023 Jan 17.

Impact of improved upper endoscopy quality on detection of gastric precancerous lesions

Guido Manfredi  1 , Marianna Pedaci  1 , Elena Iiritano  1 , Saverio Alicante  1 , Samanta Romeo  1 , Roberto Bertè  1 , Claudio Londoni  1 , Fernanda Menozzi  1 , Gianfranco Brambilla  1 , Raffaele Pezzilli  2 , Angelo Zullo  3 , Elisabetta Buscarini  1
Affiliations

Impact of improved upper endoscopy quality on detection of gastric precancerous lesions

Guido Manfredi et al. Eur J Gastroenterol Hepatol. .

Abstract

Objective: Intestinal metaplasia (IM) is the point of no return in gastric carcinogenesis, and patients with extensive (antrum plus corpus) IM are at high risk of developing gastric cancer. We evaluated the impact of improved gastroscopy quality on the detection of gastric IM in an Italian area at high risk for gastric cancer.

Methods: Data of consecutive patients with gastric biopsies according to the updated Sydney System observed in 2013, 2016 and 2019 resulting in IM diagnosis were retrieved. In the first period, endoscopy was performed with standard white light instruments. In the second period, preendoscopic gastric preparation was administered, and the examinations lasting at least 7 min with standard endoscopes were performed. In the third period, the latter procedure was followed, with virtual chromoendoscopy equipped instruments. The prevalence of IM in any gastric site and that of extensive IM were compared among the three periods.

Results: Data of 3485 patients were available. The detection of IM in at least one gastric site increased from 29.9 to 33.6% and 34.5% (95% CI, 32.1-36.8) in the first, second and third period, respectively. The difference was statistically significant between the first and last (P = 0.02; OR, 1.24; 95% CI, 1.04-1.48) period. When considering extensive IM, the detection increased from 4.28 to 6.1% and 5.44%, although the difference failed to reach statistical significance (P = 0.076).

Conclusion: Our data showed that implementation of a quality protocol increased the probability to detect IM in the stomach, allowing us to select patients deserving stricter follow-up.

PubMed Disclaimer

References

    1. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jamal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71:209–249.
    1. Arnold M, Park J, Camargo MC, Lunet N, Forman D, Soerjomataram I, et al. Is gastric cancer becoming a rare disease? A global assessment of predicted incidence trends to 2035. Gut 2020; 69:823–829.
    1. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process - First American cancer society award lecture on cancer epidemiology and prevention. Cancer Res 1992; 52:6735–6740.
    1. Rokkas T, Pistiolas D, Sechopoulos P, Robotis I, Margantinis G. The long-term impact of helicobacter pylori eradication on gastric histology: a systematic review and meta-analysis. Helicobacter 2007; 12:32–38.
    1. Yue H, Shan L, Bin L. The significance of OLGA and OLGIM staging systems in the risk assessment of gastric cancer: a systematic review and meta-analysis. Gastric Cancer 2018; 21:579–587.