title: Endoluminal Diagnosis of Early Gastric Cancer and Its Precursors: Bridging the Gap Between Endoscopy and Pathology.
abstract: Although dye-based and image-enhanced endoscopic techniques have revolutionized endoscopic diagnosis, conventional white light endoscopy still plays an important role in the diagnosis of early gastric cancer (EGC) during routine endoscopy. Chromoendoscopy reveals morphological characteristics of the mucosal lesions by enhancing mucosal contrast, while narrow-band imaging (NBI) facilitates detailed evaluation of the vascular architecture and surface features. Positive diagnostic findings of EGC on white light imaging and indigo carmine chromoendoscopy are a sharply demarcated lesion and irregularity in surface morphology or color. Magnifying NBI further improves diagnostic accuracy of white light imaging and chromoendoscopy. We review our approach to the endoscopic diagnosis of (pre-)malignant lesions in the stomach and discuss in detail novel endoscopic microvascular architectural patterns which further leverage diagnostic biopsy yield. We expect that further improvement of endoscopic techniques and correlative studies will close the gap between endoscopy and pathology.
authors: Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, 3-3 Nakamichi 1-chome, Higashinari-ku, Osaka, 537-8511, Japan. uedou-no@mc.pref.osaka.jp.
authors: Noriya
authors: N
authors: Uedo
authors: Department of Endoscopy, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 818-8502, Japan.
authors: Kenshi
authors: K
authors: Yao
mesh_terms: D001706:Biopsy; D055088:Early Detection of Cancer; D004724:Endoscopy / Q000379:methods; D016145:Endoscopy, Digestive System / Q000379:methods*; D005753:Gastric Mucosa / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D062048:Narrow Band Imaging / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013270:Stomach / Q000000981:diagnostic imaging* / Q000473:pathology; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology
keywords: Chromoendoscopy; Chronic atrophic gastritis; Early gastric cancer; Gastric cancer; Helicobacter pylori; Intestinal metaplasia; Magnification endoscopy; Narrow band imaging