Detection and characterization of early gastric cancer for curative endoscopic submucosal dissection
2013; Wiley; Volume: 25; Issue: S1 Linguagem: Inglês
10.1111/den.12004
ISSN1443-1661
AutoresKenshi Yao, Takashi Nagahama, Toshiyuki Matsui, Akinori Iwashita,
Tópico(s)Gastrointestinal Tumor Research and Treatment
ResumoBecause endoscopic submucosal dissection ( ESD ) of gastric cancer can only be curative if the cancer is detected at an early stage and a precise preoperative diagnosis is made, we reviewed the detection and characterization of early gastric cancer ( EGC ) using both conventional endoscopy with white‐light imaging ( C ‐ WLI ) and image‐enhanced endoscopy (chromoendoscopy [ CE ] and magnifying narrow‐band imaging [ M ‐ NBI ]). Systematic screening of the stomach by C ‐ WLI after ideal preparation of the patient is important for detecting a mucosal lesion, which can then be characterized using CE . However, a limitation of C ‐ WLI with CE is the diagnosis of flat or small gastric cancers. To overcome this, M ‐ NBI together with a comprehensive diagnostic system, termed the ‘vessel plus surface classification’ system, was developed and has proven very useful. Preoperative assessment for ESD involves determining: (i) histological type; (ii) size; (iii) depth of invasion; (iv) presence or absence of associated ulceration; and (v) horizontal extent of the cancer. A limitation of endoscopic diagnosis using M ‐ NBI is the histologically undifferentiated type of carcinoma, in which case the biopsy specimen is used to make a histopathological diagnosis.
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