An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

Chiu, Philip Wai Yan; Uedo, Noriya; Singh, Rajvinder; Gotoda, Takuji; Ng, Enders Kwok Wai; Yao, Kenshi; Ang, Tiing Leong; Ho, Shiaw Hooi; Kikuchi, Daisuke; Yao, Fang; Pittayanon, Rapat; Goda, Kenichi; Lau, James Y.; Tajiri, Hisao; Inoue, Haruhiro

doi:10.1136/gutjnl-2018-317111

Cited by 108 publications

(104 citation statements)

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“…We expect that this consensus will contribute to standardization of the quality of diagnostic colonoscopy in Asia and, hopefully, in other parts of the world. Future perspective of our group is to develop consensus statements on endoscopic treatment of GI neoplasia …”

Section: Discussionmentioning

confidence: 99%

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Standards of diagnostic colonoscopy for early‐stage neoplasia: Recommendations by an Asian private group

Sano¹,

Chiu

et al. 2019

Digestive Endoscopy

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Background and AimIn recent years, the incidence of colorectal cancer has been increasing, and it is now becoming the major cause of cancer death in Asian countries. The aim of the present study was to develop Asian expert‐based consensus to standardize the preparation, detection and characterization for the diagnosis of early‐stage colorectal neoplasia.MethodsA professional group was formed by 36 experts of the Asian Novel Bio‐Imaging and Intervention Group (ANBI2G) members. Representatives from 12 Asia–Pacific countries participated in the meeting. The group organized three consensus meetings focusing on diagnostic endoscopy for gastrointestinal neoplasia. The Delphi method was used to develop the consensus statements.ResultsThrough the three consensus meetings with debating, reviewing the literature and regional data, a consensus was reached at third meeting in 2016. The consensus was reached on a total of 10 statements. Summary of statements is as follows: (i) Adequate bowel preparation for high‐quality colonoscopy; (ii) Antispasmodic agents for lesion detection; (iii) Image‐enhanced endoscopy (IEE) for polyp detection; (iv) Adenoma detection rate for quality indicators; (v) Good documentation of colonoscopy findings; (vi) Complication rates; (vii) Cecal intubation rate; (viii) Cap‐assisted colonoscopy (CAC) for polyp detection; (ix) Macroscopic classification using indigocarmine spray for characterization of colorectal lesions; and (x) IEE and/or magnifying endoscopy for prediction of histology.ConclusionThis consensus provides guidance for carrying out endoscopic diagnosis and characterization for early‐stage colorectal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early‐stage colorectal neoplasia.

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Section: Discussionmentioning

confidence: 99%

“…Future perspective of our group is to develop consensus statements on endoscopic treatment of GI neoplasia. 168…”

Section: Discussionmentioning

confidence: 99%

Standards of diagnostic colonoscopy for early‐stage neoplasia: Recommendations by an Asian private group

Sano¹,

Chiu

et al. 2019

Digestive Endoscopy

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“…Though the overall survival of GC patients to some extent has improved due to the application of early detection technology and radical surgery, most early‐stage gastric cancer (EGC) patients have no characteristic manifestations, and many patients are still diagnosed at the advanced stages and miss the best chance to therapy . Nowadays, upper gastrointestinal (GI) endoscopy followed by pathologic examination remains the golden standard for the diagnosis of GC . However, upper GI endoscopy is not a routine medical examination in most countries, and making a gastroscopy inspection is an invasive technique that will sometimes make patients uncomfortable .…”

Section: Introductionmentioning

confidence: 99%

“…2 Nowadays, upper gastrointestinal (GI) endoscopy followed by pathologic examination remains the golden standard for the diagnosis of GC. 3 However, upper GI endoscopy is not a routine medical examination in most countries, and making a gastroscopy inspection is an invasive technique that will sometimes make patients uncomfortable. 4 On a global scale, a recent study showed that the 5-year survival rate of stage I patients can be more than 90%, while that of the stage IV patients who already show distant metastases is only approximately 18%.…”

Section: Introductionmentioning

confidence: 99%

Reduced expression of circRNA hsa_circ_0067582 in human gastric cancer and its potential diagnostic values

Ding

Yang

et al. 2019

Clinical Laboratory Analysis

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Background Gastric cancer (GC) is one of the global mortality diseases and has a poor prognosis due to the lack of ideal tumor biomarkers. Circular RNAs (circRNAs) are an abundant kind of endogenous RNAs that recently are found play a crucial role in the cancer occurrence and development. Nevertheless, little is known with regard to the diagnostic values of these circRNAs for GC. In this article of research, we investigated the role of hsa_circ_0067582 in clinical diagnosis of GC. Materials and Methods We used divergent primers, and the expression levels of hsa_circ_0067582 in 93 fresh GC tissues and paired adjacent normal tissues from surgical patients were detected using quantitative reverse transcription‐polymerase chain reaction (qRT‐PCR). Then, a receiver operating characteristic (ROC) curve was established to assess the diagnostic significance of hsa_circ_0067582. The relationship between expression of hsa_circ_0067582 and clinicopathological factors of patients was made further explored. Results Hsa_circ_0067582 levels were significantly decreased in GC tissues contrasted with adjacent normal tissues (n = 93, P < .001). After that, we discovered that it was evidently downregulated in 81.7% (76/93) GC tissues. The area under the ROC curve (AUC) of hsa_circ_0067582 was up to 0.6937, the sensitivity was 66.67%, and the specificity was 61.29%. Moreover, the hsa_circ_0067582 levels were obviously associated with tumor diameter (P = .002) and carbohydrate antigen 19‐9 (CA19‐9, P = .01). Meanwhile, after operation, low‐level group of hsa_circ_0067582 of GC patients was associated with better prognosis. Conclusion Our data imply that hsa_circ_000067582 may be a potential biomarker for GC diagnosis and prognosis evaluation.

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“…Consensus guidelines of standards for diagnostic upper and lower GI endoscopy have been published, and all endoscopists should be mindful of the requirements for a quality examination. (8,9) GI neoplasia, including early cancer with no or minimal risk of metastases, should undergo curative endoscopic resection. This curative treatment option is minimally invasive and organ preserving.…”

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Optimising endoscopic management of early gastrointestinal neoplasia

Ang

2019

smedj

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I n this issue of the Singapore Medical Journal, Koay et al (1) examined the role of narrow-band imaging (NBI), an image-enhanced endoscopy (IEE) technique, for the diagnosis of duodenal villous atrophy, while Li et al (2) and Tai et al (3) reported the early Singapore experience with colorectal endoscopic submucosal dissection (ESD). The aim of IEE as an adjunct to standard white light endoscopy is to improve endoscopic detection, characterisation and diagnosis of mucosal lesions. This would facilitate subsequent management strategies, including endoscopic resection or surgery. It is thus appropriate to take the opportunity to briefly examine the crucial issue of optimising endoscopic management of early gastrointestinal (GI) neoplasia. This would encompass preprocedural preparation, intraprocedural diagnosis, endoscopic treatment and post-resection follow-up options guided by histopathological findings.Endoscopy is the gold standard test for examining GI mucosa. However, to improve diagnostic yield, the mucosal surface must be clean and not obscured by mucus, fluids or other solid debris. Hence, adequate fasting, appropriate use of mucolytics and anti-foaming agents (for upper endoscopy), and good bowel preparation (for colonoscopy) are crucial. Quality endoscopic examinations are characterised by careful, deliberate and meticulous techniques. Surrogate markers of a quality examination include diagnostic procedure time, cleanliness of mucosal surface, completeness of examination, quality of captured endoscopic images and adenoma detection rates. IEE techniques are an important adjunct to white light endoscopy to improve lesion detection, characterisation and diagnosis. This may be achieved using dye spray chromoendoscopy such as the absorptive dye, Lugol's iodine, for detection of dysplastic oesophageal squamous lesions and the contrast dye, indigo carmine, which is used to highlight mildly elevated or mildly depressed mucosal lesions in the stomach and colon -or by equipment-based optical techniques. The latter techniques include NBI and blue light imaging, which focus on mucosal surface details and can be combined with optical magnification to characterise a detected lesion to determine whether it is neoplastic; if the lesion is neoplastic, the likelihood of deep submucosal involvement and feasibility of curative endoscopic resection are examined.Endoscopic classification systems based on these narrow-bandwidth imaging features have been established for the oesophagus, stomach and colon to guide treatment decisions. These include the intrapapillary capillary loop classification system for oesophageal squamous neoplasia, (4) the BING (Barrett's International NBI Group) classification system for Barrett's oesophagus, (5) the VS (vessel plus surface) classification system for early gastric cancer (6) and the NBI and JNET (Japan NBI Expert Team) classification systems for colorectal neoplasia. (7) It is important for an endoscopist to correctly describe the morphology of a detected lesion using the Paris morphol...

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An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

Cited by 108 publications

References 108 publications

Standards of diagnostic colonoscopy for early‐stage neoplasia: Recommendations by an Asian private group

Standards of diagnostic colonoscopy for early‐stage neoplasia: Recommendations by an Asian private group

Reduced expression of circRNA hsa_circ_0067582 in human gastric cancer and its potential diagnostic values

Optimising endoscopic management of early gastrointestinal neoplasia

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