title: Diagnostic utility of small-caliber and conventional endoscopes for gastric cancer and analysis of endoscopic false-negative gastric cancers.
abstract: OBJECTIVE
  To analyze the diagnostic utility of a small-caliber endoscope (SC-E) and clinicopathological features of false-negative gastric cancers (FN-GCs).
  
  
  METHODS
  A total of 21638 esophagogastroduodenoscopy (EGD) gastric cancer (GC) screening examinations were analyzed. Secondary endoscopic examinations (n = 3352) were excluded because most secondary examinations tended to be included in the conventional endoscopy (C-E) group. Detection rates of GCs and FN-GCs were compared between SC-E and C-E groups. FN-GC was defined as GC performed with EGD within the past 3 years without GC detection. Macroscopic types, histopathological characteristics and locations of FN-GCs were compared with firstly found-gastric cancers (FF-GCs) in detail.
  
  
  RESULTS
  SC-E cases (n = 6657) and C-E cases (n = 11644), a total of 18301 cases, were analyzed. GCs were detected in 16 (0.24%) SC-E cases and 40 C-E (0.34%) cases (P = 0.23) and there were 4 FN-GCs (0.06%) in SC-E and 13 (0.11%) in C-E (P = 0.27), with no significant difference. FN-GCs/GCs ratio between SC-E and C-E groups was not significantly different (P = 0.75). The comparison of endoscopic macroscopic types of FN-GCs tended to be a less advanced type (P = 0.02). Histopathologically, 70.6% of FN-GCs were differentiated and 29.4% undifferentiated type. On the other hand, 43.0% of FF-GCs were differentiated and 53.8% undifferentiated type, so FN-GCs tended to be more differentiated type (P = 0.048).
  
  
  CONCLUSIONS
  The diagnostic utility of SC-E for the detection of GCs and FN-GCs was not inferior to that of C-E. Careful observation for superficially depressed type lesions in the upper lesser curvature region is needed to decrease FN-GCs.
authors.affiliation: Hiromi Kataoka, Noriyuki Hayashi, Mamoru Tanaka, Hirotaka Nishiwaki, Masahide Ebi, Tsutomu Mizoshita, Yoshinori Mori, Eiji Kubota, Satoshi Tanida, Takeshi Kamiya, Takashi Joh, Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kataoka
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mizuno
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Hayashi
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tanaka
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Nishiwaki
authors.forename: Masahide
authors.initials: M
authors.lastname: Ebi
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Mizoshita
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Mori
authors.forename: Eiji
authors.initials: E
authors.lastname: Kubota
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tanida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kamiya
authors.forename: Takashi
authors.initials: T
authors.lastname: Joh
keywords: False-negative gastric cancer; Gastric cancer; Small-caliber endoscope
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