Evidence based review of the impact of image enhanced endoscopy in the diagnosis of gastric disorders

Abstract

Gastric cancer is the third most common cause of cancer-related death. Advanced stages of gastric cancers generally have grim prognosis. But, good prognosis can be achieved if such cancers are detected, diagnosed and resected at early stages. However, early gastric cancers and its precursors often produce only subtle mucosal changes and therefore quite commonly remain elusive at the conventional examination with white light endoscopy. Image-enhanced endoscopy makes mucosal lesions more conspicuous and can therefore potentially yield earlier and more accurate diagnoses. Recent years have seen growing work of research in support of various types of image enhanced endoscopy (IEE) techniques (e.g., dye-chromoendoscopy; magnification endoscopy; narrow-band imaging; flexible spectral imaging color enhancement; and I-SCAN) for a variety of gastric pathologies. In this review, we will examine the evidence for the utilization of various IEE techniques in the diagnosis of gastric disorders.

Does gastric stump cancer really differ from primary proximal gastric cancer? A multicentre, propensity score matching-used, retrospective cohort study

“…The 5-year survival rate of early gastric cancer patients exceeds 90%. However, the diagnostic rate of early gastric cancer is < 10%[ 4 ], and the 5-year survival rate of advanced gastric cancer is still < 50%[ 5 , 6 ]. In recent years, gastric stump cancer (GSC), which accounts for only approximately 1%-7% of gastric cancers, has attracted more attention from scholars[ 7 - 10 ].…”

Endoscopic Features of Normal and Abnormal Gastric Mucosa

“…2.3). The intramural bleeding spots may be in the form of punctate or petechiae, or confluent ecchymosis that may result in raised mucosal nodularity which may be fine or coarse [5,6]. Mild-to-moderately oedematous mucosa may be difficult to perceive in endoscopic examination, only when oedema is extensive, it may be identifiable with confidence and the mucosa appears somewhat paler or whiter accompanied by accentuation of the normal mucosal hexagonal pattern [1].…”

“…In the antral mucosa, sometimes the erosions may be seen as streaks of red spots. Friable mucosa causes punctate haemorrhages and frank oozes to minimal touch [5,6]. A severely friable mucosa tends to be markedly swollen, congested and readily bleeds, and may be covered by grey yellowish, deep red or almost blackish friable necrotic exudate.…”