Brief Article
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World J Gastrointest Endosc. Sep 16, 2013; 5(9): 440-445
Published online Sep 16, 2013. doi: 10.4253/wjge.v5.i9.440
Diagnostic utility of small-caliber and conventional endoscopes for gastric cancer and analysis of endoscopic false-negative gastric cancers
Hiromi Kataoka, Kiyoshi Mizuno, Noriyuki Hayashi, Mamoru Tanaka, Hirotaka Nishiwaki, Masahide Ebi, Tsutomu Mizoshita, Yoshinori Mori, Eiji Kubota, Satoshi Tanida, Takeshi Kamiya, Takashi Joh
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
Kiyoshi Mizuno, Division of Endoscopy, Nagoya Toei Clinic, Nagoya 460-0008, Japan
Author contributions: Kataoka H designed the research; Hayashi N, Tanaka M, Nishiwaki H, Ebi M, Mizoshita T, Mori Y, Kubota E, Tanida S, Kamiya T and Joh T performed the research; Mizuno K analyzed the data; Kataoka H wrote the paper.
Correspondence to: Hiromi Kataoka, MD, PhD, Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. hkataoka@med.nagoya-cu.ac.jp
Telephone: +81-52-8538211 Fax: +81-52-8520952
Received: April 3, 2013
Revised: May 28, 2013
Accepted: July 17, 2013
Published online: September 16, 2013
Abstract

AIM: 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).

CONCLUSION: 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.

Keywords: Gastric cancer, Small-caliber endoscope, False-negative gastric cancer

Core tip: This is the first study to reveal that the screening performance for gastric cancers by a small caliber-endoscope might not be inferior to that of conventional endoscope. Superficially depressed type lesions in the upper lesser curvature region should be carefully observed in gastric cancer screening in order to decrease false-negative gastric cancers.