Meta‐analysis: The diagnostic efficacy of chromoendoscopy for early gastric cancer and premalignant gastric lesions

Zhao, Zhanwei; Yin, Zifang; Wang, Shiqi; Wang, Juan; Bai, Bing; Qiu, Zhaoyan; Zhao, Qingchuan

doi:10.1111/jgh.13313

Cited by 64 publications

(43 citation statements)

References 47 publications

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“…A meta-analysis showed that any chromoendoscopy including indigo carmine was superior to WLE for diagnosis of EGC in terms of sensitivity and specificity, and that the addition of acetic acid further improved diagnostic accuracy 93. Several observational studies have indicated the usefulness of combining indigo carmine with acetic acid for delineation of EGC.…”

Section: Consensus Statementsmentioning

confidence: 99%

An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

Chiu

Uedo²,

Singh

et al. 2018

Gut

118

103

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BackgroundThis is a consensus developed by a group of expert endoscopists aiming to standardise the preparation, process and endoscopic procedural steps for diagnosis of early upper gastrointestinal (GI) cancers.MethodThe Delphi method was used to develop consensus statements through identification of clinical questions on diagnostic endoscopy. Three consensus meetings were conducted to consolidate the statements and voting. We conducted a systematic literature search on evidence for each statement. The statements were presented in the second consensus meeting and revised according to comments. The final voting was conducted at the third consensus meeting on the level of evidence and agreement.ResultsRisk stratification should be conducted before endoscopy and high risk endoscopic findings should raise an index of suspicion. The presence of premalignant mucosal changes should be documented and use of sedation is recommended to enhance detection of superficial upper GI neoplasms. The use of antispasmodics and mucolytics enhanced visualisation of the upper GI tract, and systematic endoscopic mapping should be conducted to improve detection. Sufficient examination time and structured training on diagnosis improves detection. Image enhanced endoscopy in addition to white light imaging improves detection of superficial upper GI cancer. Magnifying endoscopy with narrow-band imaging is recommended for characterisation of upper GI superficial neoplasms. Endoscopic characterisation can avoid unnecessary biopsy.ConclusionThis consensus provides guidance for the performance of endoscopic diagnosis and characterisation for early gastric and oesophageal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early upper GI cancers.

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Section: Consensus Statementsmentioning

confidence: 99%

An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

Chiu

Uedo²,

Singh

et al. 2018

Gut

118

103

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“…Kawahara et al also reported that the accuracy of EGC delineation was better for acetic acid-assisted chromoendoscopy than for white light endoscopy [13]. Although there is a paucity of reliable data for the effectiveness of mass screening, one metaanalysis concluded that chromoendoscopy has better diagnostic accuracy than white light endoscopy [11].…”

Section: Detecting Gastric Cancer Earliermentioning

confidence: 99%

“…Indigo carmine does not stain tissues directly, but enables visualization of the superficial topography by filling the pits and grooves on the mucosa, as well as contouring elevated areas. In addition, the combined use of indigo carmine and acetic acid improves the visualization and detection of EGC [10][11][12]. In the presence of acetic acid, it appears that the indigo carmine is washed out earlier from cancerous mucosa than from the surrounding non-cancerous mucosa with mucin secretion (Fig.…”

Section: Detecting Gastric Cancer Earliermentioning

confidence: 99%

Past and current trends in endoscopic diagnosis for early stage gastric cancer in Japan

Sumiyama

2016

Gastric Cancer

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Methodology for the diagnosis and staging of early gastric cancer (EGC) has improved in Japan since the development of the gastro-camera and determination of a definition of EGC. Imaging technology has been steadily evolving in the endoscopy field. Improvements in the resolution of standard endoscopy images used in screening and surveillance provide greater opportunities to find gastric cancer earlier. Image enhancement endoscopy (IEE), such as narrow band imaging (NBI), highlights mucosal structures and vascularity. In particular, when NBI is used with magnifying endoscopy, it reveals fine details of subtle superficial abnormalities of EGC that are difficult to recognize using standard white light endoscopy. IEE-assisted magnifying endoscopy has improved the accuracy of the differentiation of superficial gastric cancer as well as delineation of the diseased mucosa. The advanced imaging technology enables precise assessment of the risk of lymph node metastasis of EGC and is widely used to determine indications for endoscopic treatment. It is not an overstatement to say that this has become the basis for the current development and dissemination of endoscopic treatments. Moreover, the resolution of endoscopic imaging has been upgraded to the microscopy level by the development of endomicroscopy, including endocytoscopy and confocal laser endomicroscopy. Endomicroscopy allows real-time histological analysis of living tissue during routine endoscopy and may reduce the number of biopsies needed to reach the correct diagnosis, minimizing the risk of sampling errors.

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“…Magnifying endoscopy combined with staining can clearly reveal the microstructure of the gastric mucosa, guide biopsies and provide a reference for the diagnosis and differential diagnosis of gastritis as well as an early detection of intraepithelial neoplasia and intestinal metaplasia. At present, methylene blue staining combined with magnifying endoscopy still has a high diagnostic accuracy for intestinal metaplasia and intraepithelial neoplasia . Hematoxylin, indigo and acetic acid staining have diagnostic value for intraepithelial neoplasia as well …”

Section: Endoscopic Diagnosismentioning

confidence: 99%