Original Article
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Clinicopathological and endoscopic features of Helicobacter pylori infection-negative gastric cancer in Japan: a retrospective study
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Kentaro Imamura, Kenshi Yao, Satoshi Nimura, Takao Kanemitsu, Masaki Miyaoka, Yoichiro Ono, Toshiharu Ueki, Hiroshi Tanabe
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Clin Endosc 2024;57(4):486-494. Published online March 22, 2024
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DOI: https://doi.org/10.5946/ce.2023.258
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- Background
/Aims: Helicobacter pylori infection-negative gastric cancer (HPNGC) has not been systematically investigated in consecutive patients. Hence, this study aimed to investigate the clinicopathological and endoscopic features of HPNGC.
Methods
This single-center retrospective study selected participants from patients with gastric cancer who were treated at the Fukuoka University Chikushi Hospital between January 2013 and December 2021. Only patients diagnosed with HPNGC were enrolled, and their clinicopathological and endoscopic features were analyzed in detail.
Results
The prevalence of HPNGC in the present study was 2.6% (54/2112). The types of HPNGC observed in each gastric region were as follows: advanced gastric cancer was observed in the cardia; gastric adenocarcinoma of fundic-gland differentiation, gastric adenocarcinoma of foveolar-type presenting with whitish elevation and raspberry-like foveolar-type gastric adenocarcinoma, gastric adenocarcinoma arising in polyposis, and gastric adenocarcinoma with autoimmune gastritis were observed in the fundic gland region ranging from the gastric fornix to the gastric body; signet-ring cell carcinoma was observed in the gastric-pyloric transition region ranging from the lower gastric body to the gastric angle; and well-differentiated tubular adenocarcinoma with low-grade atypia was observed in the antrum.
Conclusions
This study revealed that tumors from each gastric region exhibited distinct macroscopic and histological types in HPNGC.
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Citations
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- Is your endoscopist qualified enough to detect Helicobacter pylori-naive status?
Sun-Young Lee
Clinical Endoscopy.2024; 57(4): 466. CrossRef
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Review
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E-learning system to improve the endoscopic diagnosis of early gastric cancer
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Kenshi Yao, Takashi Yao, Noriya Uedo, Hisashi Doyama, Hideki Ishikawa, Satoshi Nimura, Yuichi Takahashi
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Clin Endosc 2024;57(3):283-292. Published online August 3, 2023
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DOI: https://doi.org/10.5946/ce.2023.087
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- We developed three e-learning systems for endoscopists to acquire the necessary skills to improve the diagnosis of early gastric cancer (EGC) and demonstrated their usefulness using randomized controlled trials. The subjects of the three e-learning systems were “detection”, “characterization”, and “preoperative assessment”. The contents of each e-learning system included “technique”, “knowledge”, and “obtaining experience”. All e-learning systems proved useful for endoscopists to learn how to diagnose EGC. Lecture videos describing “the technique” and “the knowledge” can be beneficial. In addition, repeating 100 self-study cases allows learners to gain “experience” and improve their diagnostic skills further. Web-based e-learning systems have more advantages than other teaching methods because the number of participants is unlimited. Histopathological diagnosis is the gold standard for the diagnosis of gastric cancer. Therefore, we developed a comprehensive diagnostic algorithm to standardize the histopathological diagnosis of gastric cancer. Once we have successfully shown that this algorithm is helpful for the accurate histopathological diagnosis of cancer, we will complete a series of e-learning systems designed to assess EGC accurately.
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- Use of a short educational video to improve the accuracy of colorectal polyp morphology assessment: A multicenter randomized controlled study
Takahiro Utsumi, Takahiro Horimatsu, Yoshitaka Nishikawa, Akira Teramoto, Daizen Hirata, Mineo Iwatate, Shinwa Tanaka, Nobuaki Ikezawa, Masaya Esaki, Shozo Osera, Chikara Ebisutani, Hiroaki Saito, Nobukazu Agatsuma, Yukiko Hiramatasu, Yuki Nakanishi, Yasu
DEN Open.2025;[Epub] CrossRef - Pitfalls in Endoscopic Submucosal Dissection for Early Gastric Cancer with Papillary Adenocarcinoma
Gwang Ha Kim
Gut and Liver.2024; 18(3): 368. CrossRef - Comparing Raman Spectroscopy-Based Artificial Intelligence to High-Definition White Light Endoscopy for Endoscopic Diagnosis of Gastric Neoplasia: A Feasibility Proof-of-Concept Study
Tse Kiat Soong, Guo Wei Kim, Daryl Kai Ann Chia, Jimmy Bok Yan So, Jonathan Wei Jie Lee, Asim Shabbbir, Jeffrey Huey Yew Lum, Gwyneth Shook Ting Soon, Khek Yu Ho
Diagnostics.2024; 14(24): 2839. CrossRef
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Case Report
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Gastric cancer presenting with ramucirumab-related gastrocolic fistula successfully managed by colonic stenting: a case report
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Hiroki Fukuya, Yoichiro Iboshi, Masafumi Wada, Yorinobu Sumida, Naohiko Harada, Makoto Nakamuta, Hiroyuki Fujii, Eikichi Ihara
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Clin Endosc 2023;56(6):812-816. Published online May 11, 2023
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DOI: https://doi.org/10.5946/ce.2022.117
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- We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-line therapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which necessitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopy revealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonic stenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.
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- Ramucirumab
Reactions Weekly.2024; 1989(1): 189. CrossRef - Metastatic bladder cancer forming a sigmoidorectal fistula after enfortumab vedotin therapy: a case report
Shinji Tamada, Daiki Ikarashi, Naoki Yanagawa, Moe Toyoshima, Kenta Takahashi, Tomohiko Matsuura, Shigekatsu Maekawa, Renpei Kato, Mitsugu Kanehira, Ryo Takata, Wataru Obara
Frontiers in Oncology.2023;[Epub] CrossRef
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Original Articles
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The pattern of metachronous recurrence after endoscopic submucosal dissection for gastric adenocarcinoma and dysplasias
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Sunah Suk, Yeon Joo Seo, Dae Young Cheung, Han Hee Lee, Jin Il Kim, Soo-Heon Park
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Clin Endosc 2023;56(4):470-478. Published online April 18, 2023
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DOI: https://doi.org/10.5946/ce.2022.259
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- Background
/Aims: Metachronous recurrence incidences and risk factors following endoscopic submucosal dissection (ESD) for gastric adenocarcinoma and dysplasias were investigated.
Methods
Retrospective review of electronic medical records of patients who underwent gastric ESD at The Catholic University of Korea, Yeouido St. Mary’s Hospital.
Results
A total of 190 subjects were enrolled for analysis during the study period. The mean age was 64.4 years-old and the male sex occupied 73.7%. The mean observation period following ESD was 3.45 years. The annual incidence rate of metachronous gastric neoplasms (MGN) was about 3.96%. The annual incidence rate was 5.36% for the low-grade dysplasia group, 6.47% for the high-grade dysplasia group, and 2.74% for the EGC group. MGN was more frequent in the dysplasia group than in the EGC group (p<0.05). For those with MGN development, the mean time interval from ESD to MGN was 4.1 (±1.8) years. By using the Kaplan–Meier model, the estimated mean MGN free survival time was 9.97 years (95% confidence interval, 8.53–11.40) The histological types of MGN were not related to the primary histology types.
Conclusions
MGN following ESD developed in 3.96% annually and MGN was more frequent in the dysplasia group. The histological types of MGN did not correlate with those of primary neoplasm.
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Citations
Citations to this article as recorded by

- Research Progress in ESD Treatment of Early Gastric Cancer
亭 贺
Advances in Clinical Medicine.2024; 14(02): 4201. CrossRef - Optimal Surveillance of Metachronous Gastric Lesion after Endoscopic Resection of Early Gastric Cancer
Dong Chan Joo, Gwang Ha Kim
Gut and Liver.2024; 18(5): 781. CrossRef - Risk Assessment of Metachronous Gastric Neoplasm after Endoscopic Resection for Early Gastric Cancer According to Age at Helicobacter pylori Eradication
Seunghan Lee, Soo-Jeong Cho, Hyunsoo Chung, Bokyung Kim, Mi Jin Oh, Yun Suk Na, Jun Hee Lee, Jiyoon Kim, Sang Gyun Kim
Gut and Liver.2024; 18(6): 992. CrossRef
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2,639
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Exploring quality indicators for the detection of Helicobacter pylori-naïve gastric cancer: a cross-sectional nationwide survey
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Fumiaki Ishibashi, Toshiaki Hirasawa, Hiroya Ueyama, Yohei Minato, Sho Suzuki
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Clin Endosc 2023;56(4):460-469. Published online April 4, 2023
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DOI: https://doi.org/10.5946/ce.2022.167
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- Background
/Aims: Diagnosis of Helicobacter pylori-naïve gastric cancer (HPNGC) is becoming increasingly important. This study aimed to explore the quality indicators for HPNGC detection.
Methods
We conducted a cross-sectional, nationwide, web-based survey of gastrointestinal endoscopists in Japan. In addition to questions about the number of HPNGC cases detected in a year and basic information, the questionnaire also consisted of 28 questions: (1) 18 about HPNGC awareness, (2) six about diagnostic proactiveness, and (3) four about interest in HPNGC.
Results
Valid responses were obtained from 712 endoscopists. The Japan Gastroenterological Endoscopy Society-certified endoscopists had a significantly higher HPNGC detection rate than the nonspecialists (0.42% vs. 0.32%, respectively; p=0.008). The results of the multiple regression analysis showed that Japan Gastroenterological Endoscopy Society certification and high awareness and interest scores were independent predictors of the HPNGC detection rate (p=0.012, p<0.001, p=0.024, respectively). Principal component analysis showed that the endoscopists who attended conferences for collecting information on HPNGC had a higher level of awareness.
Conclusions
To improve the detection of HPNGC, it is necessary to increase the awareness of the disease. It is hoped that relevant societies will play an important role in endoscopists’ education.
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Citations
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- Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging
Hisanori Utsunomiya, Hiroya Ueyama, Tsutomu Takeda, Shunsuke Nakamura, Yasuko Uemura, Tomoyo Iwano, Momoko Yamamoto, Ryota Uchida, Daiki Abe, Shotaro Oki, Nobuyuki Suzuki, Atsushi Ikeda, Yoichi Akazawa, Kumiko Ueda, Mariko Hojo, Shuko Nojiri, Takashi Yao,
DEN Open.2025;[Epub] CrossRef - Prevalence of Gastric Epithelial Tumors in Helicobacter pylori-uninfected Individuals Undergoing a Medical Checkup
Eiko Okimoto, Kyoichi Adachi, Yuri Ebisutani, Norihisa Ishimura, Shunji Ishihara
Internal Medicine.2024; 63(16): 2251. CrossRef - A mathematical simulation model to determine the optimal endoscopic screening strategy for detection of H. pylori-naïve gastric neoplasms
Fumiaki Ishibashi, Kosuke Okusa, Yoshitaka Tokai, Toshiaki Hirasawa, Tomohiro Kawakami, Kentaro Mochida, Yuka Yanai, Chizu Yokoi, Yuko Hayashi, Shun-ichiro Ozawa, Koji Uraushihara, Yohei Minato, Hiroyuki Nakanishi, Hiroya Ueyama, Mikinori Kataoka, Yuzo To
Gastric Cancer.2024; 27(5): 1078. CrossRef - Improving the quality of the esophagogastroduodenoscopy in Helicobacter pylori-naïve gastric cancer
Jae Myung Park
Clinical Endoscopy.2023; 56(4): 453. CrossRef
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3,628
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145
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4
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Case Report
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Gastric wall abscess after endoscopic submucosal dissection
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Seung Jung Yu, Sang Heon Lee, Jun Sik Yoon, Hong Sub Lee, Sam Ryong Jee
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Clin Endosc 2023;56(1):114-118. Published online January 3, 2022
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DOI: https://doi.org/10.5946/ce.2021.203
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- Gastric wall abscess, a localized form of phlegmonous gastritis, is a rare complication of endoscopic resection. We report the first case of gastric wall abscess developing after endoscopic submucosal dissection in Korea. A 72-year-old woman visited our clinic to receive treatment for gastric adenoma. The patient successfully underwent endoscopic submucosal dissection with no complications. The final diagnosis was well-differentiated tubular adenocarcinoma. We performed follow-up endoscopy 10 weeks later and found a large subepithelial lesion on the posterior wall of the gastric antrum. Abdominal computed tomography revealed hypodense wall thickening and a 5 cm heterogenous multilobular mass in the submucosal layer of the gastric antrum. Submucosal invasion with mucin-producing adenocarcinomas could therefore not be excluded. The patient agreed to undergo additional gastrectomy due to the possibility of a highly malignant lesion. The final diagnosis was acute suppurative inflammation with the formation of multiple abscesses in the mural layers and omentum. The patient was discharged with no complications.
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Citations
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- Phlegmonous gastritis after biloma drainage: A case report and review of the literature
Kai-Chun Yang, Hsin-Yu Kuo, Jui-Wen Kang
World Journal of Clinical Cases.2022; 10(33): 12430. CrossRef
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Original Articles
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Efficacy and Safety of Endoscopic Submucosal Dissection for Superficial Gastric Neoplasms: A Latin American Cohort Study
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Fernando Palacios-Salas, Harold Benites-Goñi, Luis Marin-Calderón, Paulo Bardalez-Cruz, Jorge Vásquez-Quiroga, Edgar Alva-Alva, Bryan Medina-Morales, Jairo Asencios-Cusihuallpa
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Clin Endosc 2022;55(2):248-255. Published online November 12, 2021
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DOI: https://doi.org/10.5946/ce.2021.192
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- Background
/Aims: Endoscopic submucosal dissection (ESD) is the preferred technique for treating early gastric cancer (EGC). However, very few studies have been conducted in South America. This study aimed to assess the efficacy and safety of ESD for EGC.
Methods
We analyzed data from a prospective cohort from 2013 to 2020. A total of 152 superficial gastric neoplasms that fulfilled the absolute or expanded criteria for ESD were included. Outcomes were en bloc, R0, and curative resection rates, incidence of adverse events, and length of procedure.
Results
The age of the enrolled patients was 68.4±11.3 years. The number of included patients based on the absolute and expanded indications was 150 and 2, respectively. En bloc, R0, and curative resections were achieved in 98.0%, 96.1%, and 89.5% of the cases, respectively. Bleeding and perforation were reported in 5.9% and 6.6% of the cases, respectively. Histopathological examination revealed lowgrade dysplasia, high-grade dysplasia, well-differentiated adenocarcinoma, and poorly differentiated adenocarcinoma in 13, 20, 117, and 2 cases, respectively.
Conclusions
Our study shows that ESD performed by properly trained endoscopists in reference centers is safe and effective, with comparable therapeutic outcomes to those reported in the Eastern series.
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Citations
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- Outcomes and validity of risk stratification tools for endoscopic submucosal dissection of early gastric cancer in Western Australia
Ciaran Judge, Abir Halder, Puraskar Pateria, Tzeng Khor, Niroshan Muwanwella, Marcus Chin, Krish Ragunath
JGH Open.2024;[Epub] CrossRef - Disección submucosa endoscópica en cáncer gástrico temprano indiferenciado: evaluación de los primeros casos y análisis de su aplicación como indicación absoluta en Perú
Fernando Palacios-Salas, Luis Marin-Calderón, Juan Chirinos-Vega, Paulo Bardalez-Cruz, Patricia Valera-Luján, Dacio Cabrera-Hinojosa, Harold Benites-Goñi
Revista de Gastroenterología del Perú.2024; 44(4): 333. CrossRef - Short-Term and Long-Term Outcomes of Liver Cirrhosis in Gastric Neoplasm Patients Undergoing Endoscopic Submucosal Dissection
Xu-Rui Liu, Lian-Shuo Li, Fei Liu, Zi-Wei Li, Xiao-Yu Liu, Wei Zhang, Dong Peng
Journal of Laparoendoscopic & Advanced Surgical Techniques.2023; 33(7): 640. CrossRef - Endoscopic submucosal dissection for early gastric cancer: It is time to consider the quality of its outcomes
Gwang Ha Kim
World Journal of Gastroenterology.2023; 29(43): 5800. CrossRef - Endoscopic diagnosis of early gastric cancer
Dong Chan Joo, Gwang Ha Kim
Journal of the Korean Medical Association.2022; 65(5): 267. CrossRef - Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
Eun Jeong Gong, Chang Seok Bang
Journal of the Korean Medical Association.2022; 65(5): 284. CrossRef
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5,104
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Clinical Impact of Different Reconstruction Methods on Remnant Gastric Cancer at the Anastomotic Site after Distal Gastrectomy
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Kei Matsumoto, Shinwa Tanaka, Takashi Toyonaga, Nobuaki Ikezawa, Mari Nishio, Masanao Uraoka, Tomoatsu Yoshihara, Hiroya Sakaguchi, Hirofumi Abe, Tetsuya Yoshizaki, Madoka Takao, Toshitatsu Takao, Yoshinori Morita, Hiroshi Yokozaki, Yuzo Kodama
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Clin Endosc 2022;55(1):86-94. Published online August 13, 2021
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DOI: https://doi.org/10.5946/ce.2021.084
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- Background
/Aims: The anastomotic site after distal gastrectomy is the area most affected by duodenogastric reflux. Different reconstruction methods may affect the lesion characteristics and treatment outcomes of remnant gastric cancers at the anastomotic site. We retrospectively investigated the clinicopathologic and endoscopic submucosal dissection outcomes of remnant gastric cancers at the anastomotic site.
Methods
We recruited 34 consecutive patients who underwent endoscopic submucosal dissection for remnant gastric cancer at the anastomotic site after distal gastrectomy. Clinicopathology and treatment outcomes were compared between the Billroth II and non-Billroth II groups.
Results
The tumor size in the Billroth II group was significantly larger than that in the non-Billroth II group (22 vs. 19 mm; p=0.048). More severe gastritis was detected endoscopically in the Billroth II group (2 vs. 1.33; p=0.0075). Moreover, operation time was longer (238 vs. 121 min; p=0.004) and the frequency of bleeding episodes was higher (7.5 vs. 3.1; p=0.014) in the Billroth II group.
Conclusions
Compared to remnant gastric cancers in non-Billroth II patients, those in the Billroth II group had larger lesions with a background of severe remnant gastritis. Endoscopic submucosal dissection for remnant gastric cancers in Billroth II patients involved longer operative times and more frequent bleeding episodes than that in patients without Billroth II.
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Clinical Outcomes and Adverse Events of Gastric Endoscopic Submucosal Dissection of the Mid to Upper Stomach under General Anesthesia and Monitored Anesthetic Care
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Jong-In Chang, Tae Jun Kim, Na Young Hwang, Insuk Sohn, Yang Won Min, Hyuk Lee, Byung-Hoon Min, Jun Haeng Lee, Poong-Lyul Rhee, Jae J Kim
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Clin Endosc 2022;55(1):77-85. Published online July 5, 2021
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DOI: https://doi.org/10.5946/ce.2021.002
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- Background
/Aims: Endoscopic submucosal dissection (ESD) of gastric tumors in the mid-to-upper stomach is a technically challenging procedure. This study compared the therapeutic outcomes and adverse events of ESD of tumors in the mid-to-upper stomach performed under general anesthesia (GA) or monitored anesthesia care (MAC).
Methods
Between 2012 and 2018, 674 patients underwent ESD for gastric tumors in the midbody, high body, fundus, or cardia (100 patients received GA; 574 received MAC). The outcomes of the propensity score (PS)-matched (1:1) patients receiving either GA or MAC were analyzed.
Results
The PS matching identified 94 patients who received GA and 94 patients who received MAC. Both groups showed high rates of en bloc resection (GA, 95.7%; MAC, 97.9%; p=0.68) and complete resection (GA, 81.9%; MAC, 84.0%; p=0.14). There were no significant differences between the rates of adverse events (GA, 16.0%; MAC, 8.5%; p=0.18) in the anesthetic groups. Logistic regression analysis indicated that the method of anesthesia did not affect the rates of complete resection or adverse events.
Conclusions
ESD of tumors in the mid-to-upper stomach at our high-volume center had good outcomes, regardless of the method of anesthesia. Our results demonstrate no differences between the efficacies and safety of ESD performed under MAC and GA.
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Citations
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- Efficacy, safety, and impact on procedural outcomes of local anesthesia in endoscopic submucosal dissection: a systematic review and meta-analysis
Hazem Abosheaishaa, Abdelmalek Abdelghany, Abdallfatah Abdallfatah, Doha Mohamed, Ammar Ayman Bahbah, Islam Mohamed, Khaled Elfert, Ahmed E. Salem, Azizullah Beran, Ahmad Madkour, Mohammad Al-Haddad
Baylor University Medical Center Proceedings.2024; 37(6): 963. CrossRef - General Anesthesia and Endoscopic Upper Gastrointestinal Tumor Resection
Seung Hyun Kim
Journal of Digestive Cancer Research.2023; 11(3): 125. CrossRef - Comparing general anaesthesia versus sedation for endoscopic submucosal dissection: results from a systematic review and meta-analysis
Choy-May Leung, Rex Wan-Hin Hui
Anaesthesiology Intensive Therapy.2023; 55(1): 9. CrossRef - Is General Anesthesia Needed in Endoscopic Submucosal Dissection for Lesions Located in the Mid to Upper Stomach?
Prasit Mahawongkajit, Jirawat Swangsri
Clinical Endoscopy.2022; 55(1): 43. CrossRef - Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
Eun Jeong Gong, Chang Seok Bang
Journal of the Korean Medical Association.2022; 65(5): 284. CrossRef - Paneth Cell Carcinoma of the Stomach
Jun Wan Kim, Gwang Ha Kim, Kyung Bin Kim
The Korean Journal of Gastroenterology.2022; 80(1): 34. CrossRef - Comparing Different Anesthesia Methods on Anesthetic Effect and Postoperative Pain in Patients with Early Gastric Cancer during Endoscopic Submucosal Dissection
Jie Zhang, Yanlei Chen, Zhiwu Liu, Zhihao Pan, Jinghua Pan
Journal of Oncology.2022; 2022: 1. CrossRef
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Histological Architecture of Gastric Epithelial Neoplasias That Showed Absent Microsurface Patterns, Visualized by Magnifying Endoscopy with Narrow-Band Imaging
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Kenta Chuman, Kenshi Yao, Takao Kanemitsu, Takashi Nagahama, Masaki Miyaoka, Haruhiko Takahashi, Kentaro Imamura, Rino Hasegawa, Toshiharu Ueki, Hiroshi Tanabe, Seiji Haraoka, Akinori Iwashita
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Clin Endosc 2021;54(2):222-228. Published online November 24, 2020
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DOI: https://doi.org/10.5946/ce.2020.090
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- Background
/Aims: The objective of this study was to elucidate the histological structure of the absent microsurface patterns (MSPs) that were visualized by magnifying endoscopy with narrow-band imaging (M-NBI).
Methods
The study included consecutive gastric epithelial neoplasias for which M-NBI findings and histological findings could be compared on a one-to-one basis. The lesions were classified as absent MSPs and present MSPs based on the findings obtained using M-NBI. Of the histopathological findings for each lesion that corresponded to M-NBI findings, crypt opening densities, crypt lengths, crypt opening diameters, intercrypt distances, and crypt angles were measured and compared.
Results
Thirty-six lesions were included in the analysis; of these, 17 lesions exhibited absent MSP and 19 lesions exhibited present MSP. Comparing the histological measurements for absent MSPs vs. present MSPs, median crypt opening density was 0.9 crypt openings/mm vs. 4.8 crypt openings/mm (p<0.001), respectively. The median crypt length, median crypt opening diameter, median intercrypt distance, and median crypt angle were 80.0 μm vs. 160 μm (p<0.001), 40.0 μm vs. 44.2 μm (p=0.09), 572.5 μm vs. 166.7 μm (p<0.001), and 21.6 degrees vs. 15.5 degrees (p<0.001), respectively.
Conclusions
Histological findings showed that lesions exhibiting absent MSPs had lower crypt opening density, shorter crypt length, greater intercrypt distance, and larger crypt angle.
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Citations
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- Correlation between White Globe Appearance and Clinicopathologic Characteristics in Early Gastric Cancer
Dae Jin Jung, Gwang Ha Kim, Kyungbin Kim, Hye Kyung Jeon, Dong Chan Joo, Moon Won Lee, Bong Eun Lee
Gut and Liver.2025; 19(1): 50. CrossRef - The staining results of early gastric cancer by indigo carmine chromoendoscopy associated with histological structure: a retrospective study
Xiaosa Jiang, Lingzhi Qin, Yujie Hao, Qian Yang, Yueqin Zheng, Baicang Zou, Lei Dong, Na Liu, Jinhai Wang, Bin Qin
BMC Cancer.2024;[Epub] CrossRef - Magnifying Endoscopy with Narrow-Band Imaging for Duodenal Neuroendocrine Tumors
Gwang Ha Kim, Kiyoun Yi, Dong Chan Joo, Moon Won Lee, Hye Kyung Jeon, Bong Eun Lee
Journal of Clinical Medicine.2023; 12(9): 3106. CrossRef
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5,070
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3
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3
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Focused Review Series: Application of Artificial Intelligence in GI Endoscopy
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Lesion-Based Convolutional Neural Network in Diagnosis of Early Gastric Cancer
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Hong Jin Yoon, Jie-Hyun Kim
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Clin Endosc 2020;53(2):127-131. Published online March 30, 2020
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DOI: https://doi.org/10.5946/ce.2020.046
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- Diagnosis and evaluation of early gastric cancer (EGC) using endoscopic images is significantly important; however, it has some limitations. In several studies, the application of convolutional neural network (CNN) greatly enhanced the effectiveness of endoscopy. To maximize clinical usefulness, it is important to determine the optimal method of applying CNN for each organ and disease. Lesion�-based CNN is a type of deep learning model designed to learn the entire lesion from endoscopic images. This review describes the application of lesion-based CNN technology in diagnosis of EGC.
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Citations
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- Past, Present, and Future
Sarah Enslin, Vivek Kaul
Gastrointestinal Endoscopy Clinics of North America.2025; 35(2): 265. CrossRef - Revolutionizing diagnosis of pulmonary Mycobacterium tuberculosis based on CT: a systematic review of imaging analysis through deep learning
Fei Zhang, Hui Han, Minglin Li, Tian Tian, Guilei Zhang, Zhenrong Yang, Feng Guo, Maomao Li, Yuting Wang, Jiahe Wang, Ying Liu
Frontiers in Microbiology.2025;[Epub] CrossRef - A reconstruction and convolution operations enabled variant vision transformer with gastroscopic images for automatic locating of polyps in Internet of Medical Things
Zhe Qin, Yaqiong Zhang, Jian Li, Deming Li, Yanqing Mo, Liyang Wang, Peiyu Qian, Li Feng
Information Fusion.2024; 101: 102007. CrossRef - Diagnosis of gastric cancer in role of endoscopic imaging techniques in artificial intelligence and machine learning applications: An overview
Pooja K., Kishore Kanna R., G. Li, U. Subramaniam, M. Sekar
E3S Web of Conferences.2024; 491: 03016. CrossRef - Using RNN Artificial Neural Network to Predict the Occurrence of Gastric Cancer in the Future of the World
Seyed Masoud Ghoreishi Mokri, Newsha Valadbeygi, Khafaji Mohammed Balyasimovich
International Journal of Innovative Science and Research Technology (IJISRT).2024; : 1865. CrossRef - Advanced Detection of Chronic Atrophic Gastritis Using High-Resolution Endoscopy and Semantic Web
Junyi Zhao, Yaxin Gao, Jinbao Li
International Journal on Semantic Web and Information Systems.2024; 20(1): 1. CrossRef - A review on recent advances of AI-integrated microfluidics for analytical and bioanalytical applications
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Clinical Practice Guideline for Endoscopic Resection of Early Gastrointestinal Cancer
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Chan Hyuk Park, Dong-Hoon Yang, Jong Wook Kim, Jie-Hyun Kim, Ji Hyun Kim, Yang Won Min, Si Hyung Lee, Jung Ho Bae, Hyunsoo Chung, Kee Don Choi, Jun Chul Park, Hyuk Lee, Min-Seob Kwak, Bun Kim, Hyun Jung Lee, Hye Seung Lee, Miyoung Choi, Dong-Ah Park, Jong Yeul Lee, Jeong-Sik Byeon, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Hoon Jai Chun
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Clin Endosc 2020;53(2):142-166. Published online March 30, 2020
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DOI: https://doi.org/10.5946/ce.2020.032
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- Although surgery was the standard treatment for early gastrointestinal cancers, endoscopic resection is now a standard treatment for early gastrointestinal cancers without regional lymph node metastasis. High-definition white light endoscopy, chromoendoscopy, and image-enhanced endoscopy such as narrow band imaging are performed to assess the edge and depth of early gastrointestinal cancers for delineation of resection boundaries and prediction of the possibility of lymph node metastasis before the decision of endoscopic resection. Endoscopic mucosal resection and/or endoscopic submucosal dissection can be performed to remove early gastrointestinal cancers completely by en bloc fashion. Histopathological evaluation should be carefully made to investigate the presence of risk factors for lymph node metastasis such as depth of cancer invasion and lymphovascular invasion. Additional treatment such as radical surgery with regional lymphadenectomy should be considered if the endoscopically resected specimen shows risk factors for lymph node metastasis. This is the first Korean clinical practice guideline for endoscopic resection of early gastrointestinal cancer. This guideline was developed by using mainly de novo methods and encompasses endoscopic management of superficial esophageal squamous cell carcinoma, early gastric cancer, and early colorectal cancer. This guideline will be revised as new data on early gastrointestinal cancer are collected.
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Citations
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The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2021; 21(1): 72. CrossRef - Endoscopic Submucosal Dissection versus Surgery for Undifferentiated-Type Early Gastric Cancer: A Systematic Review and Meta-Analysis
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The Annals of Thoracic Surgery.2021; 111(5): 1689. CrossRef - Recent advances in early esophageal cancer: diagnosis and treatment based on endoscopy
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Kyoungwon Jung
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Hang Yang, Bing Hu
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Original Articles
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Quality Indicators for the Detection of Helicobacter pylori-Negative Early Gastric Cancer: A Retrospective Observational Study
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Fumiaki Ishibashi, Konomi Kobayashi, Keita Fukushima, Ryu Tanaka, Tomohiro Kawakami, Junko Kato, Kazuaki Sugihara
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Clin Endosc 2020;53(6):698-704. Published online March 13, 2020
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DOI: https://doi.org/10.5946/ce.2019.203
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Abstract
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- Background
/Aims: While Helicobacter pylori (HP)-negative gastric cancer is frequently reported, little is known about the predictors for detecting HP-negative early gastric cancer (EGC). We aimed to evaluate the predictors for the detection of HP-negative EGC.
Methods
We retrospectively reviewed 13,477 consecutive asymptomatic cases where upper endoscopy was performed by nine physicians from April 2017 to March 2019 and analyzed the detection rate of high-risk lesions (HRLs), including EGC, tubular adenoma, and lymphoma, according to the status of HP infection. The observation time was corrected for multiple regression analyses.
Results
For all physicians, the average observation time for screening HP-eradicated and -naïve patients was shorter than that for screening HP-positive patients (p<0.05). Multiple regression analyses revealed that the observation time in the three groups was an independent predictor for detecting HRLs in HP-eradicated patients (p=0.03106, 0.01263, and 0.02485, respectively), while experience of endoscopy was an independent predictor for detecting HRLs in HP-naïve patients (p=0.02638).
Conclusions
While observation time during screening endoscopy was a quality indicator for detecting HRLs in HP-eradicated patients, experience of endoscopy was a quality indicator for detecting HRLs in HP-naïve patients.
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Citations
Citations to this article as recorded by

- Management of epithelial precancerous conditions and early neoplasia of the stomach (MAPS III): European Society of Gastrointestinal Endoscopy (ESGE), European Helicobacter and Microbiota Study Group (EHMSG) and European Society of Pathology (ESP) Guideli
Mário Dinis-Ribeiro, Diogo Libânio, Hugo Uchima, Manon C.W. Spaander, Jan Bornschein, Tamara Matysiak-Budnik, Georgios Tziatzios, João Santos-Antunes, Miguel Areia, Nicolas Chapelle, Gianluca Esposito, Gloria Fernandez-Esparrach, Lumir Kunovsky, Mónica Ga
Endoscopy.2025; 57(05): 504. CrossRef - A mathematical simulation model to determine the optimal endoscopic screening strategy for detection of H. pylori-naïve gastric neoplasms
Fumiaki Ishibashi, Kosuke Okusa, Yoshitaka Tokai, Toshiaki Hirasawa, Tomohiro Kawakami, Kentaro Mochida, Yuka Yanai, Chizu Yokoi, Yuko Hayashi, Shun-ichiro Ozawa, Koji Uraushihara, Yohei Minato, Hiroyuki Nakanishi, Hiroya Ueyama, Mikinori Kataoka, Yuzo To
Gastric Cancer.2024; 27(5): 1078. CrossRef - Exploring quality indicators for the detection of Helicobacter pylori-naïve gastric cancer: a cross-sectional nationwide survey
Fumiaki Ishibashi, Toshiaki Hirasawa, Hiroya Ueyama, Yohei Minato, Sho Suzuki
Clinical Endoscopy.2023; 56(4): 460. CrossRef - A Close Follow-Up Strategy in the Short Period of Time after Helicobacter pylori Eradication Contributes to Earlier Detection of Gastric Cancer
Fumiaki Ishibashi, Sho Suzuki, Mizuki Nagai, Kentaro Mochida, Konomi Kobayashi, Tetsuo Morishita
Digestion.2023; 104(3): 165. CrossRef - Endoscopic diagnosis of early gastric cancer
Dong Chan Joo, Gwang Ha Kim
Journal of the Korean Medical Association.2022; 65(5): 267. CrossRef - Risk factors for early gastric cancer: focus on Helicobacter pylori gastritis
Hee Seok Moon
Journal of the Korean Medical Association.2022; 65(5): 259. CrossRef - Tailored eradication strategy vs concomitant therapy for Helicobacter pylori eradication treatment in Korean patients
Youn I Choi, Jun-Won Chung, Kyoung Oh Kim, Kwang An Kwon, Yoon Jae Kim, Jung Ho Kim, Ja Young Seo, Dong Kyun Park
World Journal of Gastroenterology.2021; 27(31): 5247. CrossRef - Quality management system for screening esophagogastroduodenoscopy improves detection of Helicobacter pylori-negative interval gastric cancer
Fumiaki Ishibashi, Konomi Kobayashi, Tomohiro Kawakami, Ryu Tanaka, Kazuaki Sugihara, Satoshi Baba
Endoscopy International Open.2021; 09(12): E1900. CrossRef - Quality Indicator for Gastric Cancer Detection Based on Helicobacter pylori Status
Jae Myung Park
Clinical Endoscopy.2020; 53(6): 629. CrossRef
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Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers
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Jaesin Lee, Byung-Wook Kim, Cheal Wung Huh, Joon Sung Kim, Lee-So Maeng
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Clin Endosc 2020;53(3):328-333. Published online January 7, 2020
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DOI: https://doi.org/10.5946/ce.2019.133
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Abstract
PDF
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ePub
- Background
/Aims: Predicting histological ulceration in early gastric cancer (EGC) during endoscopic examination is crucial for endoscopists deciding on the treatment modality. The aim of this study was to investigate the endoscopic factors that can predict histological ulcerations in EGCs.
Methods
We retrospectively analyzed patients who underwent endoscopic submucosal dissection (ESD) for EGC. Clinical features and endoscopic characteristics of EGC such as location, histological differentiation, longest diameter, tumor morphology, mucosal break, converging fold, color change, and surface irregularity were reviewed. Histological ulceration was defined based on ESD specimens.
Results
A total of 633 EGC lesions from 613 patients were included and histological ulcerations were found in 90 lesions (14.2%). Presence of converging folds, tumor morphology, and color changes on endoscopic examination were related to histological ulceration in the univariate analysis and converging folds along with color changes were statistically significant factors in the multivariate analysis. Kaplan–Meier analysis showed that patients with histological ulcerations in EGCs tended to have higher marginal recurrence rates.
Conclusions
Mucosal breaks are not equivalent to histological ulcerations. Rather, the existence of converging folds and color changes during endoscopic examination suggest histological ulcerations. Endoscopists should consider these factors when they decide the treatment modality for EGCs.
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Citations
Citations to this article as recorded by

- Clinical Impact of Proton Pump Inhibitor and Potassium-Competitive Acid Blocker for Predicting the Curability of Endoscopic Resection in Ulcerative Early Gastric Cancer
Konomu Uno, Takaya Shimura, Shingo Inaguma, Keita Kuroyanagi, Ruriko Nishigaki, Takuya Kanno, Makiko Sasaki, Shigeki Fukusada, Naomi Sugimura, Yusuke Mizuno, Takayuki Nukui, Yuki Kojima, Mamoru Tanaka, Keiji Ozeki, Eiji Kubota, Satoru Takahashi, Hiromi Ka
Digestion.2024; 105(3): 192. CrossRef - Identification of maximal tumor size associated with negligible lymph node metastasis for endoscopic submucosal dissection of undifferentiated-type early gastric cancer
Sung Eun Oh, Soomin Ahn, Kyoung-Mee Kim, Min-Gew Choi, Jun Ho Lee, Tae Sung Sohn, Jae Moon Bae, Ji Yeong An
Gastric Cancer.2024; 27(4): 850. CrossRef - Endoscopic diagnosis of early gastric cancer
Dong Chan Joo, Gwang Ha Kim
Journal of the Korean Medical Association.2022; 65(5): 267. CrossRef - Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
Eun Jeong Gong, Chang Seok Bang
Journal of the Korean Medical Association.2022; 65(5): 284. CrossRef - Construction and analysis of an ulcer risk prediction model after endoscopic submucosal dissection for early gastric cancer
San-Dong Gong, Huan Li, Yi-Bin Xie, Xiao-Hui Wang
World Journal of Gastrointestinal Oncology.2022; 14(9): 1823. CrossRef - Long‑term outcome of the endoscopic submucosal dissection of early gastric cancer: A comparison between patients with and without liver cirrhosis
Seung Kim, Moon Joo, Ah-Young Yoo, Seong Kim, Won Kim, Beom Lee, Jong Park, Hoon Chun, Sang Lee
Oncology Letters.2022;[Epub] CrossRef - Discrepancy between endoscopic and pathological ulcerative findings in clinical intramucosal early gastric cancer
Yohei Yabuuchi, Kohei Takizawa, Naomi Kakushima, Noboru Kawata, Masao Yoshida, Yoichi Yamamoto, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Hirotoshi Ishiwatari, Kinichi Hotta, Hiroyuki Matsubayashi, Etsuro Bando, Masanori Terashima, Takashi Sugino, Hiro
Gastric Cancer.2021; 24(3): 691. CrossRef - What is the Most Precise Endoscopic Finding for Predicting the Clinicopathological Behaviors in Ulcerative Early Gastric Cancer?
Youngdae Kim
Clinical Endoscopy.2020; 53(3): 249. CrossRef
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Risk Factors and Clinical Outcomes of Non-Curative Resection in Patients with Early Gastric Cancer Treated with Endoscopic Submucosal Dissection: A Retrospective Multicenter Study in Korea
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Si Hyung Lee, Min Cheol Kim, Seong Woo Jeon, Kang Nyeong Lee, Jong Jae Park, Su Jin Hong, Korean Society of Gastrointestinal Endoscopy Endoscopic Submucosal Dissection Research Group
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Clin Endosc 2020;53(2):196-205. Published online October 25, 2019
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DOI: https://doi.org/10.5946/ce.2019.123
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Abstract
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ePub
- Background
/Aims: The purpose of this study was to investigate the risk factors and long-term clinical outcomes of non-curative resection (NCR) in a large-scale patient population.
Methods
We retrospectively analyzed the clinical data of 3,094 patients who underwent endoscopic submucosal dissection (ESD) of early gastric cancer from March 2005 to March 2018 at 13 institutions in Korea. We analyzed the risk factors for NCR and the survival between patients with curative resection and those with NCR with no additional treatment.
Results
The NCR rate was 21.4% (661/3,094). In multivariate regression analysis, the risk factors affecting NCR with ESD were old age, undifferentiated tumor, tumor location in the upper body, tumor size ≥2 cm, and presence of an ulcer. In Cox proportional hazard regression analysis, tumor size ≥2 cm, submucosal invasion, positive horizontal margin, and lymphovascular invasion were risk factors for local recurrence. In Kaplan-Meier analysis, there was no statistically significant difference in the overall survival between the two groups (log-rank p=0.788). However, disease-specific survival was significantly lower in the NCR group (log-rank p=0.038).
Conclusions
Clinicians should be aware of the risk factors for NCR and local recurrence after ESD for early gastric cancer, and should consider providing additional treatment after NCR.
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Citations
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Review
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Assessment of Endoscopic Gastric Atrophy according to the Kimura-Takemoto Classification and Its Potential Application in Daily Practice
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Duc Trong Quach, Toru Hiyama
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Clin Endosc 2019;52(4):321-327. Published online July 22, 2019
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DOI: https://doi.org/10.5946/ce.2019.072
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Abstract
PDF
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ePub
- The assessment of endoscopic gastric atrophy (EGA) according to the Kimura-Takemoto classification has been reported to correlate well with histological assessment. Although agreement among beginner endoscopists was less than that among experienced endoscopists, it has been shown that agreement level could markedly improve and remained stable after proper training. Several cohort studies have consistently shown that the severity of EGA at baseline is significantly associated with the presence of advanced precancerous gastric lesions and gastric cancer, as well as the development of gastric cancer in future. Patients with moderate-to-severe EGA still have high risk of gastric cancer even after successful Helicobacter pylori eradication and should be candidates for gastric cancer surveillance. The assessment of EGA, therefore, could be used as a preliminary tool to identify individuals at high risk for gastric cancer. In this paper, we review the agreement on mucosal atrophy assessment between the Kimura-Takemoto classification and histology as well as the potential application of this endoscopic classification to identify precancerous gastric lesions and gastric cancer in daily practice.
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Dehua Liu, Si Chen, Yawen Gou, Wenyong Yu, Hangcheng Zhou, Rutong Zhang, Jinghao Wang, Fei Ye, Yingling Liu, Baolin Sun, Kaiguang Zhang
Frontiers in Cellular and Infection Microbiology.2021;[Epub] CrossRef - Use of endoscopic assessment of gastric atrophy for gastric cancer risk stratification to reduce the need for gastric mapping
Duc Trong Quach, Toru Hiyama, Huy Minh Le, Trung Sao Nguyen, Takuji Gotoda
Scandinavian Journal of Gastroenterology.2020; 55(4): 402. CrossRef - Influence of hypergastrinemia secondary to long-term proton pump inhibitor treatment on ECL cell tumorigenesis in human gastric mucosa
Atsushi Tatsuguchi, Shintaro Hoshino, Noriyuki Kawami, Katya Gudis, Tsutomu Nomura, Akira Shimizu, Katsuhiko Iwakiri
Pathology - Research and Practice.2020; 216(10): 153113. CrossRef - Chronic atrophic gastritis detection with a convolutional neural network considering stomach regions
Misaki Kanai, Ren Togo, Takahiro Ogawa, Miki Haseyama
World Journal of Gastroenterology.2020; 26(25): 3650. CrossRef - Naiv Helicobacter pylori pozitif ve negatif hastaların klinik, demografik ve endoskopik karakteristikleri: Retrospektif analiz
Muhammet AYDIN
Endoskopi Gastrointestinal.2020; 28(2): 39. CrossRef - Gastrointestinal Microbiota Changes in Patients With Gastric Precancerous Lesions
Dehua Liu, Si Chen, Yawen Gou, Wenyong Yu, Hangcheng Zhou, Rutong Zhang, Jinghao Wang, Fei Ye, Yingling Liu, Baolin Sun, Kaiguang Zhang
SSRN Electronic Journal .2020;[Epub] CrossRef
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Original Article
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Immunohistochemical Expression of Epithelial-Mesenchymal Transition Markers in Early Gastric Cancer: Cancer Tissue versus Noncancer Tissue
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Hee Jae Jung, Su Jin Hong, Shin Hee Kim
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Clin Endosc 2019;52(5):464-471. Published online May 22, 2019
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DOI: https://doi.org/10.5946/ce.2018.181
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Abstract
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- Background
/Aims: Epithelial-mesenchymal transition (EMT) is a developmental process, wherein the epithelial cells show reduced intercellular adhesions and acquire migratory fibroblastic properties. EMT is associated with downregulation in epithelial marker expression, abnormal translocation of E-cadherin, and upregulation in mesenchymal marker expression. Here, we investigated the immunohistochemical (IHC) expression of EMT markers in early gastric cancer (EGC) between cancer and noncancer tissues.
Methods
Tissue samples were prospectively obtained from 19 patients with EGC that underwent endoscopic submucosal dissection (ESD). We compared the expression level of transforming growth factor (TGF)-β, vascular endothelial growth factor (VEGF), E-cadherin, α-smooth muscle actin (α-SMA), and vimentin between cancer and noncancer tissues using IHC. Among the 19 patients, 15 patients had follow-up biopsy at 3 months after ESD for EGC.
Results
Cancer tissues presented higher values of EMT mesenchymal markers (α-SMA/vimentin/TGF-β/VEGF) than the noncancerous tissues (p<0.05) that were significantly low after ESD (p<0.05). No significant correlation was reported for tumor location and initial Helicobacter pylori infection.
Conclusions
The mesenchymal expression of EMT markers was higher in the cancerous tissues than in the noncancer tissues.
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Reihaneh Alsadat Mahmoudian, Fatemeh Fardi Golyan, Mohammad Mahdi Forghanifard, Mehran Gholamin, Atena Mansouri, Hamid Tanzadehpanah, Mohammad Reza Abbaszadegan
Human Gene.2025; 44: 201394. CrossRef - Gastric Carcinoma with low ROR alpha, low E- Cadherin and High LAPTM4B Immunohistochemical Profile; is associated with unfavorable prognosis in Egyptian patients
Shereen Nagib El Mashad, Mona Abd El Halim Kandil, Taysseer Abd El-Hamid Talab, Abd El Naby Saied Abd El Naby, Mervat Mahmoud Sultan, Ahmed Sohaib, Aiat Shaban Hemida
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Guofeng Ma, Wen Xue, Jie Ni, Ran Tao, Xiangya Ding
Journal of Oncology.2022; 2022: 1. CrossRef - Investigating Helicobacter pylori-related pyloric hypomotility: functional, histological, and molecular alterations
Aya Aly Ashraf, Sarah Mahmoud Gamal, Hend Ashour, Basma Emad Aboulhoda, Laila Ahmed Rashed, Inas Anas Harb, Gaber Hassan Abdelfattah, Eman Ahmed El-Seidi, Heba Mohamed Shawky
American Journal of Physiology-Gastrointestinal and Liver Physiology.2021; 321(5): G461. CrossRef
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5
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Focused Review Series: Endoscopic Submucosal Dissection for Undifferentiated-Type Early Gastric Cancer
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Is Radical Surgery Necessary for All Patients Diagnosed as Having Non-Curative Endoscopic Submucosal Dissection?
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Si Hyung Lee, Byung Sam Park
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Clin Endosc 2019;52(1):21-29. Published online January 30, 2019
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DOI: https://doi.org/10.5946/ce.2019.014
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Abstract
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- If a lesion does not meet the expanded indication criteria for treatment with endoscopic therapy for early gastric cancer or does not have a positive resection margin, it is regarded as suitable for non-curative resection. Non-curative resection is closely related to the risk of local recurrence, lymph node metastasis, and poor prognosis. If the result is confirmed as non-curative resection, additional treatment should be considered depending on the risks of residual tumor, local recurrence, and lymph node metastasis. As lymphatic invasion is the most important risk factor of recurrence and poor prognosis, surgical treatment should be considered if lymphatic invasion is present. If patients are not suitable for additional surgery owing to old age or coexisting severe disease, close surveillance can be an alternative treatment option.
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Citations
Citations to this article as recorded by

- Risk Factors and Clinical Outcomes of Non-Curative Resection in Patients with Early Gastric Cancer Treated with Endoscopic Submucosal Dissection: A Retrospective Multicenter Study in Korea
Si Hyung Lee, Min Cheol Kim, Seong Woo Jeon, Kang Nyeong Lee, Jong Jae Park, Su Jin Hong
Clinical Endoscopy.2020; 53(2): 196. CrossRef
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6,890
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106
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1
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1
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Focused Review Series: Current Status of Image-Enhanced Endoscopy (IEE)
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Linked Color Imaging and Blue Laser Imaging for Upper Gastrointestinal Screening
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Hiroyuki Osawa, Yoshimasa Miura, Takahito Takezawa, Yuji Ino, Tsevelnorov Khurelbaatar, Yuichi Sagara, Alan Kawarai Lefor, Hironori Yamamoto
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Clin Endosc 2018;51(6):513-526. Published online November 2, 2018
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DOI: https://doi.org/10.5946/ce.2018.132
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Abstract
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- White light imaging (WLI) may not reveal early upper gastrointestinal cancers. Linked color imaging (LCI) produces bright images in the distant view and is performed for the same screening indications as WLI. LCI and blue laser imaging (BLI) provide excellent visibility of gastric cancers in high color contrast with respect to the surrounding tissue. The characteristic purple and green color of metaplasias on LCI and BLI, respectively, serve to increase the contrast while visualizing gastric cancers regardless of a history of Helicobacter pylori eradication.
LCI facilitates color-based recognition of early gastric cancers of all morphological types, including flat lesions or those in an H. pylori-negative normal background mucosa as well as the diagnosis of inflamed mucosae including erosions. LCI reveals changes in mucosal color before the appearance of morphological changes in various gastric lesions. BLI is superior to LCI in the detection of early esophageal cancers and abnormal findings of microstructure and microvasculature in close-up views of upper gastrointestinal cancers. Excellent images can also be obtained with transnasal endoscopy. Using a combination of these modalities allows one to obtain images useful for establishing a diagnosis. It is important to observe esophageal cancers (brown) using BLI and gastric cancers (orange) surrounded by intestinal metaplasia (purple) and duodenal cancers (orange) by LCI.
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Citations
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Masahiro Saito, Tomoyuki Koike, Yuki Ohara, Yohei Ogata, Takeshi Kanno, Xiaoyi Jin, Waku Hatta, Kaname Uno, Naoki Asano, Akira Imatani, Atsushi Masamune
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Jae Gon Lee, In Kyung Yoo, Abdullah Ozgur Yeniova, Sang Pyo Lee
Gut and Liver.2024; 18(3): 444. CrossRef - Diagnostic performance of blue laser imaging for early detection of gastric cancer: A systematic review and meta-analysis
Mohammed Rifat Shaik, Andrew Canakis, Nishat Anjum Shaik, Shivanand Bomman, Dushyant Singh Dahiya, Emily Gorman, Mohammad Bilal, Saurabh Chandan
Indian Journal of Gastroenterology.2024; 43(5): 976. CrossRef - Cromoendoscopia virtual utilizando BLI en el diagnóstico endoscópico de esófago de Barrett neoplásico y no neoplásico
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Masato Tsunoda, Yoshimasa Miura, Hiroyuki Osawa, Manabu Nagayama, Yuka Kagaya, Yohei Funayama, Takuma Kobayashi, Mami Togashi, Hiroki Hayashi, Yuji Hiraoka, Yoshie Nomoto, Chihiro Iwashita, Yuji Ino, Haruo Takahashi, Hisashi Fukuda, Alan Kawarai Lefor, Hi
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真 徐
Advances in Clinical Medicine.2023; 13(04): 6577. CrossRef - Helicobacter pylori Infection: Conventional and Molecular Strategies for
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Reza Ranjbar, Amir Ebrahimi, Amirhossein Sahebkar
Current Pharmaceutical Biotechnology.2023; 24(5): 647. CrossRef - Linked color imaging versus conventional white light colonoscopy for the detection of colorectal polyps
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Sang Pyo Lee
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Ken Haruma, Mototsugu Kato, Kenro Kawada, Takahisa Murao, Shoko Ono, Mitsuhiko Suehiro, Shinichiro Hori, Fumisato Sasaki, Tomoyuki Koike, Shinji Kitamura, Osamu Dohi, Hiromitsu Kanzaki, Nobuaki Yagi, Keiichi Hashiguchi, Shiro Oka, Kazuhiro Katada, Ryo Shi
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Young Jung Kim, Sun-Young Lee, Jeong Hwan Kim, In-Kyung Sung, Hyung Seok Park
Clinical Endoscopy.2022; 55(1): 67. CrossRef - Linked color imaging effectively detects the endoscopic atrophic border in transnasal endoscopy
Yusuke Kawai, Mitsushige Sugimoto, Mariko Hamada, Eri Iwata, Ryota Niikura, Naoyoshi Nagata, Masakatsu Fukuzawa, Takao Itoi, Takashi Kawai
Journal of Clinical Biochemistry and Nutrition.2022; 70(3): 290. CrossRef - Linked color imaging improves identification of early gastric cancer lesions by expert and non-expert endoscopists
Kiki Fockens, Jeroen de Groof, Joost van der Putten, Tsevelnorov Khurelbaatar, Hisashi Fukuda, Takahito Takezawa, Yoshimasa Miura, Hiroyuki Osawa, Hironori Yamamoto, Jacques Bergman
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Journal of the Korean Medical Association.2022; 65(5): 259. CrossRef - Diagnostic accuracy of linked colour imaging versus white light imaging for early gastric cancers: a prospective, multicentre, randomized controlled trial study
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Maria Pina Dore, Giovanni Mario Pes
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Sang Pyo Lee, Sea Hyub Kae, Hyun Joo Jang, Dong Hee Koh, Eun Suk Jung
Journal of Digestive Diseases.2021; 22(7): 425. CrossRef - Appropriate Color Enhancement Settings for Blue Laser Imaging Facilitates the Diagnosis of Early Gastric Cancer with High Color Contrast
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Journal of Gastric Cancer.2021; 21(2): 142. CrossRef - Application of linked color imaging in the diagnosis of early gastrointestinal neoplasms and precancerous lesions: a review
Shanshan Wang, Lei Shen, Hesheng Luo
Therapeutic Advances in Gastroenterology.2021;[Epub] CrossRef - Association between abdominal symptoms and gastric body redness in Linked Color Imaging in patients without Helicobacter pylori infection
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Hang Yang, Bing Hu
Diagnostics.2021; 11(8): 1305. CrossRef - Clinical Applications of Linked Color Imaging and Blue Laser/Light Imaging in the Screening, Diagnosis, and Treatment of Superficial Colorectal Tumors
Taku Sakamoto, Hourin Cho, Yutaka Saito
Clinical Endoscopy.2021; 54(4): 488. CrossRef - Application of Current Image-Enhanced Endoscopy in Gastric Diseases
Wansik Lee
Clinical Endoscopy.2021; 54(4): 477. CrossRef - Linked-color Imaging May Help Improve the Visibility of Superficial Barrett's Esophageal Adenocarcinoma by Increasing the Color Difference
Masahiro Saito, Tomoyuki Koike, Yuki Ohara, Kenichiro Nakagawa, Takeshi Kanno, Xiaoyi Jin, Waku Hatta, Kaname Uno, Naoki Asano, Akira Imatani, Atsushi Masamune
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Takeshi Yasuda, Tomoyuki Hiroyasu, Satoru Hiwa, Yuto Okada, Sadanari Hayashi, Yuki Nakahata, Yuriko Yasuda, Tatsushi Omatsu, Akihiro Obora, Takao Kojima, Hiroshi Ichikawa, Nobuaki Yagi
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Yasuhiko Abe, Yu Sasaki, Takashi Kon, Yoshiyuki Ueno
Internal Medicine.2020; 59(12): 1573. CrossRef - Optical enhancement imaging versus acetic acid for detecting gastric intestinal metaplasia: A randomized, comparative trial
Rui Ji, Jun Liu, Ming-Ming Zhang, Yue-Yue Li, Xiu-Li Zuo, Xiao Wang, Yan-Qing Li
Digestive and Liver Disease.2020; 52(6): 651. CrossRef - The Efficacy of Linked Color Imaging in the Endoscopic Diagnosis of Barrett’s Esophagus and Esophageal Adenocarcinoma
Mamoru Tokunaga, Tomoaki Matsumura, Kentaro Ishikawa, Tatsuya Kaneko, Hirotaka Oura, Tsubasa Ishikawa, Ariki Nagashima, Wataru Shiratori, Kenichiro Okimoto, Naoki Akizue, Daisuke Maruoka, Yuki Ohta, Keiko Saito, Tomoo Nakagawa, Tetsuhiro Chiba, Makoto Ara
Gastroenterology Research and Practice.2020; 2020: 1. CrossRef - Linked color imaging can improve the visibility of superficial non-ampullary duodenal epithelial tumors
Kenichiro Okimoto, Daisuke Maruoka, Tomoaki Matsumura, Mamoru Tokunaga, Tatsuya Kaneko, Hirotaka Oura, Naoki Akizue, Yuki Ohta, Keiko Saito, Makoto Arai, Jun Kato, Naoya Kato
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Joon Sung Kim, Byung-Wook Kim
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Athanasios Makristathis, Alexander M. Hirschl, Francis Mégraud, Emilie Bessède
Helicobacter.2019;[Epub] CrossRef - New Diagnostic Approach for Esophageal Squamous Cell Neoplasms Using Linked Color Imaging and Blue Laser Imaging Combined with Iodine Staining
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Clinical Endoscopy.2019; 52(5): 497. CrossRef - Linked color imaging for the detection of early gastrointestinal neoplasms
Satoshi Shinozaki, Hiroyuki Osawa, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
Therapeutic Advances in Gastroenterology.2019;[Epub] CrossRef - Linked Color Imaging Highlights Flat Early Gastric Cancer
Kimitoshi Kubo, Noriko Kimura, Soichiro Matsuda, Momoko Tsuda, Mototsugu Kato
Case Reports in Gastroenterology.2019; 13(3): 532. CrossRef
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Case Reports
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A Rare Case of Lymph Node Metastasis from Early Gastric Cancer
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Takaaki Yoshikawa, Yoshio Kadokawa, Masaya Ohana, Akihisa Fukuda, Hiroshi Seno
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Clin Endosc 2019;52(4):369-372. Published online October 5, 2018
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DOI: https://doi.org/10.5946/ce.2018.130
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Abstract
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- Gastric cancers that fulfill the Japanese criteria for curative endoscopic resection show a low risk of lymph node (LN) metastasis. Here, we report a case of LN metastasis from early gastric cancer that fulfilled the curative criteria. A 74-year-old Japanese woman was referred to our hospital for treatment of early gastric cancer identified at the site of a hyperplastic polyp that had been diagnosed 10 years prior to presentation. Contrast-enhanced computed tomography did not show any lymphadenopathy and laparoscopy-assisted distal gastrectomy was performed. Histopathological examination revealed a predominantly moderately differentiated adenocarcinoma that measured 15 mm in size and was confined to the mucosa. However, a single metastatic regional LN was observed. A few cancer cells showed positive staining for alpha-fetoprotein. It should be noted that early gastric cancer can be accompanied by LN metastasis even if it fulfills the criteria for curative endoscopic resection.
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Citations
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- Alpha-fetoprotein-producing intramucosal gastric cancer found during examination of metastatic lymph nodes
Tomoya Sano, Takahiro Toyokawa, Mami Yoshii, Yuichiro Miki, Tatsuro Tamura, Shigeru Lee, Kiyoshi Maeda
Clinical Journal of Gastroenterology.2025; 18(1): 57. CrossRef
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Blue Laser Imaging with a Small-Caliber Endoscope Facilitates Detection of Early Gastric Cancer
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Haruo Takahashi, Yoshimasa Miura, Hiroyuki Osawa, Takahito Takezawa, Yuji Ino, Masahiro Okada, Alan Kawarai Lefor, Hironori Yamamoto
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Clin Endosc 2019;52(3):273-277. Published online August 14, 2018
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DOI: https://doi.org/10.5946/ce.2018.100
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Abstract
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- Conventional endoscopy often misses early gastric cancers with minimal red discoloration because they cannot be distinguished from inflamed mucosa. We treated a patient with a small early gastric cancer that was difficult to diagnose using conventional endoscopy. Conventional endoscopy using a small-caliber endoscope showed only subtle red discoloration of the gastric mucosa. However, blue laser imaging showed a clearly discolored area measuring 10 mm in diameter around the red lesion, which was distinct from the surrounding inflamed mucosa. Irregular vessels on the tumor surface (suspicious for early gastric cancer) were observed even with small-caliber endoscopy. Biopsy revealed a well-moderately differentiated tubular adenocarcinoma, and endoscopic submucosal dissection was performed. Histopathological examination of the specimen confirmed well-moderately differentiated adenocarcinoma localized to the mucosa with slight depression compared to the surrounding mucosa, consistent with the endoscopic findings. This small early gastric cancer became clearly visible with blue laser imaging using small-caliber endoscopy.
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Citations
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- Diagnostic performance of blue laser imaging for early detection of gastric cancer: A systematic review and meta-analysis
Mohammed Rifat Shaik, Andrew Canakis, Nishat Anjum Shaik, Shivanand Bomman, Dushyant Singh Dahiya, Emily Gorman, Mohammad Bilal, Saurabh Chandan
Indian Journal of Gastroenterology.2024; 43(5): 976. CrossRef - Improved detection of early gastric cancer with linked color imaging using an ultrathin endoscope: a video-based analysis
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Review
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Metachronous Gastric Cancer Following Curative Endoscopic Resection of Early Gastric Cancer
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Seiichiro Abe, Ichiro Oda, Takeyoshi Minagawa, Masau Sekiguchi, Satoru Nonaka, Haruhisa Suzuki, Shigetaka Yoshinaga, Amit Bhatt, Yutaka Saito
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Clin Endosc 2018;51(3):253-259. Published online September 18, 2017
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DOI: https://doi.org/10.5946/ce.2017.104
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Abstract
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- This review article summarizes knowledge about metachronous gastric cancer (MGC) occurring after curative endoscopic resection (ER) of early gastric cancer (EGC), treatment outcomes of patients who developed MGC, and efficacy of Helicobacter pylori eradication to prevent MGC. The incidence of MGC following curative ER increases over time and is higher than in patients undergoing gastrectomy. Increasing age and multifocal EGC are independent risk factors for developing MGC. An MGC following curative ER is usually a small (<20 mm) and differentiated intramucosal cancer. Most MGC lesions are found at an early stage on semiannual or annual surveillance endoscopy and are successfully treated by further ER, with excellent long-term outcomes. Eradication of H. pylori may reduce the risk of MGC following ER of EGC, but further prospective studies with long-term outcomes are required. Surveillance endoscopy following gastric ER should be continued indefinitely, due to the risk of MGC even after successful H. pylori eradication. Risk stratification and tailored endoscopic surveillance schedules need to be developed.
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Hiroyuki Osawa, Yoshimasa Miura, Takahito Takezawa, Yuji Ino, Tsevelnorov Khurelbaatar, Yuichi Sagara, Alan Kawarai Lefor, Hironori Yamamoto
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Case Report
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A Rare Case of Early Gastric Cancer Combined with Underlying Heterotopic Pancreas
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Jung Bin Yoon, Bong Eun Lee, Dae Hwan Kim, Do Youn Park, Hye Kyung Jeon, Dong Hoon Baek, Gwang Ha Kim, Geun Am Song
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Clin Endosc 2018;51(2):192-195. Published online August 31, 2017
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DOI: https://doi.org/10.5946/ce.2017.055
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Abstract
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- Heterotopic pancreas in the stomach is usually asymptomatic and benign. Here, we presented a rare case of an early gastric cancer overlying a heterotopic pancreas. A 48-year-old woman underwent esophagogastroduodenoscopy, which revealed a subepithelial mass measuring 2.0×1.5 cm on the gastric antrum with a 1-cm erosive erythematous discoloration on the surface. A biopsy specimen showed moderately differentiated tubular adenocarcinoma. Endosonography showed a heterogeneous hypoechoic mass measuring 1.3×0.6 cm, with indistinct margins in the second and third layers of the gastric wall; anechoic tubular structures within the mass were suggestive of heterotopic pancreas. Distal gastrectomy was performed, which confirmed an early gastric cancer confined to the mucosa, and a separate underlying heterotopic pancreas. Although heterotopic pancreas is most likely benign, careful endoscopic observation of the mucosal surface is necessary to avoid overlooking a coincident early gastric cancer.
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- Duodenal Heterotopic Pancreas with a Large Retention Cyst: A Case Report and Literature Review
Shinya Kawaguchi, Akinori Murakami, Masato Nishida
Internal Medicine.2023; 62(5): 723. CrossRef - Gastric ectopic pancreas combined with synchronous multiple early gastric cancer: A rare case report
Zhen-Ya Zhao, Yue-Xing Lai, Ping Xu
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Keiso Matsubara, Michihiro Ishida, Toshiaki Morito, Tetsushi Kubota, Yasuhiro Choda, Masao Harano, Hiroyoshi Matsukawa, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima
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Shoko Iwahashi, Masaaki Nishi, Toshiaki Yoshimoto, Hideya Kashihara, Chie Takasu, Takuya Tokunaga, Tomohiko Miyatani, Jun Higashijima, Kozo Yoshikawa, Yuma Wada, Yoshimi Bando, Mitsuo Shimada
Surgical Case Reports.2019;[Epub] CrossRef
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Focused Review Series: Endoscopic Accessories Used for ESD
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Future Development of Endoscopic Accessories for Endoscopic Submucosal Dissection
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Jae-Young Jang
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Clin Endosc 2017;50(3):242-249. Published online May 31, 2017
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DOI: https://doi.org/10.5946/ce.2017.073
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Abstract
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- Endoscopic submucosal dissection (ESD) has recently been accepted as a standard treatment for patients with early gastric cancer (EGC), without lymph node metastases. Given the rise in the number of ESDs being performed, new endoscopic accessories are being developed and existing accessories modified to facilitate the execution of ESD and reduce complication rates. This paper examines the history underlying the development of these new endoscopic accessories and indicates future directions for the development of these accessories.
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Takao Tonishi, Fumiaki Ishibashi, Kosuke Okusa, Kentaro Mochida, Sho Suzuki
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Jie Xia, Wenxin Wang, Jinghui Guo, Jinglei Wu, Xinjian Wan
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Therapeutic Advances in Gastrointestinal Endoscopy.2020; 13: 263177452095722. CrossRef
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7
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Reviews
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How to Interpret the Pathological Report before and after Endoscopic Submucosal Dissection of Early Gastric Cancer
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Dae Young Cheung, Soo-Heon Park
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Clin Endosc 2016;49(4):327-331. Published online July 25, 2016
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DOI: https://doi.org/10.5946/ce.2016.082
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Abstract
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- Possible lymph node metastasis (LNM) and residual cancer are major concerns in endoscopic submucosal dissection (ESD) for early gastric cancer. To reduce the risk of LNM and cancer recurrence, the proper indications for ESD should be considered. Histology, size, depth of invasion, and presence of ulceration should be thoroughly evaluated before proceeding with ESD. However, with incomplete information, discrepancies often arise between the pathological diagnosis based on the forceps biopsy and that based on the totally resected specimen. In addition, the presence of lymphovascular involvement and histological homogeneity can be clarified only after ESD. If the pathological diagnosis changes after ESD, we should reevaluate the curativeness and reformulate the goal of treatment. Additional surgery is a reasonable strategy for non-curative ESD, but a patient’s other health conditions should also be considered. It is simple to read pathological reports before and after ESD, but it can be a complicated art to interpret the report and formulate an optimal approach. In this review, various considerations regarding the pathological diagnosis will be discussed.
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Ting Sun, Xi-quan Ke, Meng Wang, Qi-zhi Wang
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Yu Xiao, Zhigang Song, Shuangmei Zou, Yan You, Jie Cui, Shuhao Wang, Calvin Ku, Xi Wu, Xiaowei Xue, Wenqi Han, Weixun Zhou
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Jung Won Jeon, Soo Jin Kim, Jae Young Jang, Sun-Moon Kim, Chul-Hyun Lim, Jae Myung Park, Su Jin Hong, Chan Gyoo Kim, Seong Woo Jeon, Si Hyung Lee, Jae Kyu Sung, Gwang Ho Baik
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Borrmann Type 4 Advanced Gastric Cancer: Focus on the Development of Scirrhous Gastric Cancer
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Kyoungwon Jung, Moo In Park, Sung Eun Kim, Seun Ja Park
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Clin Endosc 2016;49(4):336-345. Published online July 25, 2016
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DOI: https://doi.org/10.5946/ce.2016.057
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Abstract
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- Early diagnosis of Borrmann type 4 advanced gastric cancer (AGC) is very important for improving the prognosis of AGC patients. Because there is no definite mass in most cases of Borrmann type 4 AGC, its accurate diagnosis via endoscopy requires an understanding of its pathogenesis and developmental process. Moreover, many people confuse linitis plastica (LP) type gastric cancer (GC), scirrhous GC, and Borrmann type 4 AGC. To distinguish each of these cancers, knowledge of their endoscopic and pathological differences is necessary, especially for LP type GCs in the developmental stage. In conclusion, diagnosis of pre-stage or latent LP type GC before progression to typical LP type GC requires the detection of IIc-like lesions in the fundic gland area. It is also crucial to identify any abnormalities such as sclerosis of the gastric wall and hypertrophy of the mucosal folds during endoscopy.
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Treatment Strategy after Incomplete Endoscopic Resection of Early Gastric Cancer
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Sang Gyun Kim
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Clin Endosc 2016;49(4):332-335. Published online July 20, 2016
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DOI: https://doi.org/10.5946/ce.2016.069
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Abstract
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- Endoscopic resection of early gastric cancer is defined as incomplete when tumor cells are found at the resection margin upon histopathological examination. However, a tumor-positive resection margin does not always indicate residual tumor; it can also be caused by tissue contraction during fixation, by the cautery effect during endoscopic resection, or by incorrect histopathological mapping. Cases of highly suspicious residual tumor require additional endoscopic or surgical resection. For inoperable patients, argon plasma coagulation can be used as an alternative endoscopic treatment. Immediately after the incomplete resection or residual tumor has been confirmed by the pathologist, clinicians should also decide upon any additional treatment to be carried out during the follow-up period.
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Focused Review Series: Image Enhanced Endoscopy
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Clinical Application of Magnifying Endoscopy with Narrow-Band Imaging in the Stomach
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Kenshi Yao
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Clin Endosc 2015;48(6):481-490. Published online November 30, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.6.481
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Abstract
PDF
PubReader
ePub
- Magnifying endoscopy with narrow-band imaging (M-NBI) can visualize superficial microanatomies in the stomach. The normal morphology of the microanatomy visualized by M-NBI differs according to the part of the stomach. The gastric fundic glandular mucosa appears as a regular honeycomb-like subepithelial capillary network (SECN) pattern with a regular collecting venule pattern and regular oval crypt opening with circular marginal crypt epithelium (MCE) pattern. The gastric pyloric glandular mucosa displays a regular coil-shaped SECN pattern and regular polygonal or curved MCE pattern. For a diagnosis of early gastric cancer using M-NBI, the vessel plus surface classification system was developed. This system is clinically useful for the differential diagnosis of focal gastritis and small depressed cancer and for determining the horizontal extent of early gastric cancer for successful endoscopic resection. Advantages of M-NBI over conventional endoscopic imaging techniques with white light include accurate diagnosis and cost effectiveness. This technique is a breakthrough in the endoscopic diagnostic field.
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Review
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Improving the Endoscopic Detection Rate in Patients with Early Gastric Cancer
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Hee Seok Moon
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Clin Endosc 2015;48(4):291-296. Published online July 24, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.4.291
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Abstract
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Endoscopists should ideally possess both sufficient knowledge of the endoscopic gastrointestinal disease findings and an appropriate attitude. Before performing endoscopy, the endoscopist must identify several risk factors of gastric cancer, including the patient's age, comorbidities, and drug history, a family history of gastric cancer, previous endoscopic findings of atrophic gastritis or intestinal metaplasia, and a history of previous endoscopic treatments. During endoscopic examination, the macroscopic appearance is very important for the diagnosis of early gastric cancer; therefore, the endoscopist should have a consistent and organized endoscope processing technique and the ability to comprehensively investigate the entire stomach, even blind spots.
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Journal of the Korean Medical Association.2022; 65(5): 259. CrossRef - Redundant Electromagnetic Control of an Endoscopic Magnetic Capsule Driven by Multiple Electromagnets Configuration
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Clinical Endoscopy.2015; 48(4): 269. CrossRef - Detection of gastric cancer using transabdominal ultrasonography is associated with tumor diameter and depth of invasion
MINORU TOMIZAWA, FUMINOBU SHINOZAKI, KAZUNORI FUGO, RUMIKO HASEGAWA, YOSHINORI SHIRAI, YASUFUMI MOTOYOSHI, TAKAO SUGIYAMA, SHIGENORI YAMAMOTO, TAKASHI KISHIMOTO, NAOKI ISHIGE
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Case Report
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Liver Metastasis of Early Gastric Cancer with Mixed Histology after Endoscopic Submucosal Dissection
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Yang Hee Han, Jong Kyu Park, Jun Sung Kwon, Young Don Kim, Woo Jin Jeong, Sang Jin Lee, Koon Hee Han, Gab Jin Cheon
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Clin Endosc 2015;48(3):247-250. Published online May 29, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.3.247
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Abstract
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The Japanese Classification of Gastric Carcinoma histologically classifies endoscopically resected gastric cancer into differentiated and undifferentiated types according to the presence or absence of tubular structures on histology. The former includes papillary adenocarcinoma and tubular types, and the latter includes poorly differentiated adenocarcinoma, signet ring cell carcinoma and mucinous adenocarcinoma. However, gastric cancer sometimes contains a mixture of differentiated and undifferentiated components, and the clinical outcomes of the histological mixture are unknown, especially following endoscopic resection of early gastric cancer (EGC). This case was within the guideline indications for endoscopic submucosal resection (ESD), although it contained a partly signet ring cell carcinoma component; it recurred after 19 months with multiple lymph node and liver metastases. This case shows that additional surgical resection after ESD should be performed for patients with any mixed signet ring cell component, even in mild or moderately differentiated EGC.
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Naoki Ikari, Kiyoaki Taniguchi, Akiko Serizawa, Takuji Yamada, Masakazu Yamamoto, Toru Furukawa
Journal of Hepato-Biliary-Pancreatic Sciences.2017; 24(5): 281. CrossRef
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