Endocytoscopy is a promising modality with high diagnostic accuracy for gastric cancer

Kaise, Mitsuru; Ohkura, Yasuo; Iizuka, Toshiro; Kimura, Ryusuke; Nomura, Kosuke; Kuribayashi, Yasutaka; Yamada, Akihiro; Yamashita, Satoshi; Furuhata, Tsukasa; Kikuchi, Daisuke; Ogawa, Osamu; Matsui, Akira; Mitani, Toshifumi; Hoteya, Shu

doi:10.1055/s-0034-1377965

Cited by 38 publications

(34 citation statements)

References 9 publications

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“…Apart from conventional endoscopy, magnifying endoscopy combined with narrow-band imaging (NBI) has been recently introduced in the diagnosis of early GC [4, 12] improving the specificity, the sensitivity and the accuracy of the diagnosis [13, 14]. However, missed diagnosis of GC on endoscopy is a common occurrence, with false-negative rates ranging among 5–19% [4, 15, 16].…”

Section: Introductionmentioning

confidence: 99%

Early detection of gastric cancer using global, genome-wide and IRF4, ELMO1, CLIP4 and MSC DNA methylation in endoscopic biopsies

et al. 2017

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Clinically useful molecular tools to triage gastric cancer patients are not currently available. We aimed to develop a molecular tool to predict gastric cancer risk in endoscopy-driven biopsies obtained from high-risk gastric cancer clinics in low resource settings.We discovered and validated a DNA methylation biomarker panel in endoscopic samples obtained from 362 patients seen between 2004 and 2009 in three high-risk gastric cancer clinics in Lima, Perú, and validated it in 306 samples from the Cancer Genome Atlas project (“TCGA”). Global, epigenome wide and gene-specific DNA methylation analyses were used in a Phase I Biomarker Development Trial to identify a continuous biomarker panel that combines a Global DNA Methylation Index (GDMI) and promoter DNA methylation levels of IRF4, ELMO1, CLIP4 and MSC.We observed an inverse association between the GDMI and histological progression to gastric cancer, when comparing gastritis patients without metaplasia (mean = 5.74, 95% CI, 4.97−6.50), gastritis patients with metaplasia (mean = 4.81, 95% CI, 3.77−5.84), and gastric cancer cases (mean = 3.38, 95% CI, 2.82−3.94), respectively (p < 0.0001). Promoter methylation of IRF4 (p < 0.0001), ELMO1 (p < 0.0001), CLIP4 (p < 0.0001), and MSC (p < 0.0001), is also associated with increasing severity from gastritis with no metaplasia to gastritis with metaplasia and gastric cancer.Our findings suggest that IRF4, ELMO1, CLIP4 and MSC promoter methylation coupled with a GDMI>4 are useful molecular tools for gastric cancer risk stratification in endoscopic biopsies.

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Section: Introductionmentioning

confidence: 99%

Early detection of gastric cancer using global, genome-wide and IRF4, ELMO1, CLIP4 and MSC DNA methylation in endoscopic biopsies

et al. 2017

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“…ECS has been shown to have high diagnostic accuracy (sensitivity 86% specificity 100%) for gastric cancer. However, in this study, 10 of the 82 lesions investigated could not be clearly observed by ECS due to poor staining due to viscous mucus or plaque 49. Sato et al 50 further demonstrated that ECS could differentiate between normal antrum mucosa and preneoplastic changes, whereby they were able to identify four different mucosal patterns in the antrum in a small single-centre pilot study consisting of 64 patients, where the positive predictive values for associating type 1 pattern for normal mucosa and type 4 pattern for gastric intestinal metaplasia were both 100%.…”

Section: Emerging Technologiesmentioning

confidence: 56%

Advanced endoscopic imaging in gastric neoplasia and preneoplasia

Lee

Lim

Yeoh

2017

BMJ Open Gastroenterol

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Conventional white light endoscopy remains the current standard in routine clinical practice for early detection of gastric cancer. However, it may not accurately diagnose preneoplastic gastric lesions. The technological advancements in the field of endoscopic imaging for gastric lesions are fast growing. This article reviews currently available advanced endoscopic imaging modalities, in particular chromoendoscopy, narrow band imaging and confocal laser endomicroscopy, and their corresponding evidence shown to improve diagnosis of preneoplastic gastric lesions. Raman spectrometry and polarimetry are also introduced as promising emerging technologies.

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“…The combination of image‐enhanced endoscopy and magnifying endoscopy is an established modality to narrow the differential diagnosis of suspicious lesions, although a final diagnosis still requires histopathological assessment of specimens obtained using endoscopic biopsy . Endocytoscopy and confocal microscopy may provide future alternatives, but these modalities are not common . Future modalities may minimize the number of unnecessary endoscopic biopsies.…”

Section: Future Perspectivesmentioning

confidence: 99%

Recent clinical management of antithrombotic agents for gastrointestinal endoscopy after revision of guidelines in Japan

Ono

Fujishiro

Ikeda

et al. 2015

Digestive Endoscopy

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In 2012, the Japan Gastroenterological Endoscopy Society (JGES) revised guidelines for the management of gastrointestinal endoscopy for patients using antithrombotic agents. The conventional guidelines emphasized reducing the bleeding risk that accompanies gastrointestinal endoscopy, but the present guidelines prioritize reduction of thromboembolism risk during discontinuation of antithrombotic agents, which is consistent with Western guidelines. When the advantages outweigh the disadvantages, the guidelines permit endoscopic biopsy and high‐bleeding‐risk procedures without discontinuation of selected antithrombotic agents. These guidelines created a paradigm shift that has slowly, but surely, changed clinical daily practice in Japan. As a result, endoscopic biopsy without discontinuation of antithrombotic agents has been widely accepted, although solid evidence for its support is still lacking. Additionally, feasibility of high‐bleeding‐risk procedures without discontinuation of selected antithrombotic agents is also controversial because evidence newly acquired after publication of the present guidelines is low in evidence level. Consequently, clinical studies with a high evidence level, including randomized controlled studies, are mandatory to establish reliable upcoming guidelines. At the same time, under the present guidelines, the accomplishment of such studies in Japan is expected.

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Endocytoscopy is a promising modality with high diagnostic accuracy for gastric cancer

Abstract: ECS is a clinically feasible modality to obtain in vivo histology, with high diagnostic accuracy in gastric cancer.

Cited by 38 publications

References 9 publications

Early detection of gastric cancer using global, genome-wide and IRF4, ELMO1, CLIP4 and MSC DNA methylation in endoscopic biopsies

Early detection of gastric cancer using global, genome-wide and IRF4, ELMO1, CLIP4 and MSC DNA methylation in endoscopic biopsies

Advanced endoscopic imaging in gastric neoplasia and preneoplasia

Recent clinical management of antithrombotic agents for gastrointestinal endoscopy after revision of guidelines in Japan

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