Detection and Characterization of Early Gastric Cancer

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.

Extracellular vesicles in gastric cancer: role of exosomal lncRNA and microRNA as diagnostic and therapeutic targets

“…The process of GC development, progression, invasion, and metastasis is also closely linked to changes in gene expression, gene mutations, and epigenetic alterations ( Herrera-Pariente et al, 2021 ; Liu Y. et al, 2022 ; Jelski and Mroczko, 2022 ). Despite GC being preventable, the prevalence of early screening is still low, leading to a high percentage of GC patients being in the late-stage tumor by initial diagnosis, which hinders surgical intervention success, exhibits an increased metastasis rate and carries a dismal prognosis ( Li G. Z. et al, 2022 ; Ferreira et al, 2022 ). The primary treatment strategies for early to mid-stage GC are surgery, adjuvant chemotherapy, and radiotherapy ( Puliga et al, 2021 ; Fong et al, 2022 ).…”

Analysis of high risk factors for chronic atrophic gastritis

“…In addition, the accuracy of histologic biopsy depends on the accurate localization of the biopsy taken by the endoscopist and the expertise of the pathologist, which often requires multiple biopsies during a single gastroscopy, increasing the risk of bleeding and gastric ulcers. Although CAG can be diagnosed clinically according to the Kimura–Takemoto endoscopic classification,[ 6 ] strict training of endoscopists is required, and the accuracy remains to be verified. Therefore, effective and reliable non-invasive screening of CAG which improves the positivity and accuracy of gastroscopy is needed.…”

Modern Approaches to <i>H. pylori</i> Eradication Therapy in Adults (Literature Review and Resolution of Experts Council)

“…Последнее может быть связано с возрастным увеличением выраженности атрофических изменений и нарастанием риска развития кишечной метаплазии [23]. Это положение повторяет заключение предыдущего консенсуса, в котором наиболее эффективной мерой профилактики рака желудка считается своевременное проведение эрадикации H. pylori до развития тяжелого атрофического гастрита [24].…”