The role of endoscopy in the management of premalignant and malignant conditions of the stomach

Evans, John A.; Chandrasekhara, Vinay; Chathadi, Krishnavel V.; Decker, G. Anton; Early, Dayna S.; Fisher, Deborah A.; Foley, Kimberly; Hwang, Joo Ha; Jue, Terry L.; Lightdale, Jenifer R.; Pasha, Shabana F.; Sharaf, Ravi; Shergill, Amandeep K.; Cash, Brooks D.; DeWitt, John M.

doi:10.1016/j.gie.2015.03.1967

Cited by 247 publications

(166 citation statements)

References 109 publications

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“…The Western endoscopy societies have issued practice guidelines for endoscopic management of premalignant and malignant condition/lesions in the oesophagus114 115 and the stomach 116. Most guidelines recommend use of WLE and/or random biopsies to make a diagnosis of those premalignant lesions, but they do not include endoscopic practice for detection and characterisation of early upper GI cancers using IEE.…”

Section: Discussionmentioning

confidence: 99%

An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

Chiu

Uedo²,

Singh

et al. 2018

Gut

123

103

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BackgroundThis is a consensus developed by a group of expert endoscopists aiming to standardise the preparation, process and endoscopic procedural steps for diagnosis of early upper gastrointestinal (GI) cancers.MethodThe Delphi method was used to develop consensus statements through identification of clinical questions on diagnostic endoscopy. Three consensus meetings were conducted to consolidate the statements and voting. We conducted a systematic literature search on evidence for each statement. The statements were presented in the second consensus meeting and revised according to comments. The final voting was conducted at the third consensus meeting on the level of evidence and agreement.ResultsRisk stratification should be conducted before endoscopy and high risk endoscopic findings should raise an index of suspicion. The presence of premalignant mucosal changes should be documented and use of sedation is recommended to enhance detection of superficial upper GI neoplasms. The use of antispasmodics and mucolytics enhanced visualisation of the upper GI tract, and systematic endoscopic mapping should be conducted to improve detection. Sufficient examination time and structured training on diagnosis improves detection. Image enhanced endoscopy in addition to white light imaging improves detection of superficial upper GI cancer. Magnifying endoscopy with narrow-band imaging is recommended for characterisation of upper GI superficial neoplasms. Endoscopic characterisation can avoid unnecessary biopsy.ConclusionThis consensus provides guidance for the performance of endoscopic diagnosis and characterisation for early gastric and oesophageal neoplasia based on the evidence. This will enhance the quality of endoscopic diagnosis and improve detection of early upper GI cancers.

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Section: Discussionmentioning

confidence: 99%

An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

Chiu

Uedo²,

Singh

et al. 2018

Gut

123

103

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“…In polyps larger than 2 cm, there was a 50% rate of adenocarcinoma foci. Due to the high potential of malignancy, these lesions should be submitted for complete excision and follow up to ensure that there is no recurrence (7) . In our work, there was a substantial agreement between pathologists for this histological type, with all lesions being removed completely without presenting dysplastic foci.…”

Section: Discussionmentioning

confidence: 99%

“…In our work, there was a substantial agreement between pathologists for this histological type, with all lesions being removed completely without presenting dysplastic foci. The gastric adenomas have a high rate of malignant transformation, and a precise diagnosis of these lesions is fundamental, in order to perform a complete resection of these polyps (7) . Thus, this fact demonstrates clearly the relevance of our study.…”

Section: Discussionmentioning

confidence: 99%

“…In this series, hyperplastic polyps were the most frequent and accounted for 71.3% of the cases, whereas fundic gland polyps accounted for 16.33% and adenomatous polyps for 12.4% (13) . The fundic gland polyps are not aggressive, with dysplasia rarely being observed (1%) (7,8) . The hyperplastic polyps rarely affect the normal mucosa, are strongly related to the use of proton pump inhibitors (PPIs), and they rarely undergo neoplastic transformation (8) .…”

Section: Introductionmentioning

confidence: 99%

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Agreement Between Different Pathologists in Histopathologic Diagnosis of 128 Gastric Polyps

Barbosa

Filho

Franco

et al. 2017

Arq. Gastroenterol.

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BACKGROUND - Gastric polyps are elevated mucosal lesions. Most of them are less than 1 cm and when larger than 2 cm, has a high malignancy probability. The histopathological types are mainly fundic gland polyps, hyperplastic polyps and adenomatous polyps. OBJECTIVE - To evaluate the agreement between three different pathologists in the histopathological diagnosis of 128 biopsied gastric polyps in Digestive Endoscopy Unit from Walter Cantídeo University Hospital, between May 2010 to May 2012. METHODS - To describe the intensity of agreement between observers, we use kappa index that is based on the number of concordant measures between them. RESULTS - There was substantial agreement in the diagnosis of adenoma (kappa=0.799, CI: 0.899-0.698) and fundic glands (kappa=0.655, CI: 0.755-0.555). Regarding to hyperplastic polyps (kappa=0.415, CI: 0.515-0.315) and inflammatory (kappa=0.401, CI: 0.501-0.301), we obtained a moderate agreement. Regarding the presence of Helicobacter pylori in biopsy of the polyp, there was a low agreement (kappa=0.219, CI: 0.319-0.119). CONCLUSION - It is clear that the agreement between pathologists depends on the histological type of the biopsied polyp and this agreement is more substantial in adenoma, or fundic gland polyps.

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“…A follow-up upper endoscopy can be arranged for most patients after 4–6 weeks to establish healing or exclude other diagnoses. There is no current guideline or recommendation on the role of routine endoscopic surveillance for gastric perforation secondary to either peptic ulcer19 or metastasis disease 20…”

Section: Discussionmentioning

confidence: 99%

Gastric perforation secondary to metastasis from breast cancer

et al. 2016

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Gastric perforation secondary to metastasis from breast cancer occurs infrequently. We present the case of a 72-year-old postmenopausal female patient with a known history of lobular carcinoma of the breast who presented to a district general hospital with a clinical diagnosis of an acute abdomen. Further contrast-enhanced CT scan demonstrated free gas and fluid in the abdomen. She underwent emergency exploratory laparotomy and onlay Graham's omentopexy patch due to 1×1 cm prepyloric gastric perforation. Final histopathology proved the presence of metastatic malignant cells in the breast origin. We discuss the issues involved in postoperative investigation and management.

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The role of endoscopy in the management of premalignant and malignant conditions of the stomach

Cited by 247 publications

References 109 publications

An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

An Asian consensus on standards of diagnostic upper endoscopy for neoplasia

Agreement Between Different Pathologists in Histopathologic Diagnosis of 128 Gastric Polyps

Gastric perforation secondary to metastasis from breast cancer

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