![]() ![]() These patients had previously undergone endoscopic ultrasonography and computed tomography assessments, and were scheduled to undergo ESD or surgery. Therefore, the current study was performed to prospectively investigate the diagnostic performance of AI chromoendoscopy in delineating differentiated or undifferentiated adenocarcinomas in patients with EGC.įrom January 2007 to May 2009, a total of 151 lesions in 141 patients (85 men and 56 women age range, 35-81 years mean age 60 years) with an endoscopic diagnosis of EGC were enrolled prospectively. However, the majority of subjects included in these studies had differentiated adenocarcinomas. Chromoendoscopy with indigo carmine dye added to acetic acid (AI chromoendoscopy) has recently been reported to improve the diagnostic yield in terms of recognizing the tumor borders in patients with EGC. Therefore, easier methods are required that make it possible to accurately determine the lateral extent of these tumors. Magnifying endoscopes have reportedly been useful in overcoming this difficulty but their use is limited by the technical difficulties in manipulating the scopes. However, it is sometimes difficult to identify the margins of the tumors, especially those of superficial or flat-type tumors. This has traditionally been done with conventional endoscopy and chromoendoscopy using indigo carmine dye. To achieve a successful outcome, it is very important to accurately determine the lateral extent of the tumor. As a result, endoscopic treatments such as endoscopic submucosal dissection (ESD) and laparoscopic gastrectomy are increasingly used to treat a subset of patients with EGC in both Korea and Japan. The proportion of EGC cases is increasing in Korea because endoscopic screening for gastric cancer has been adopted. Early gastric cancer (EGC) is defined as a gastric cancer that is confined to the mucosa or submucosa, regardless of the presence or absence of lymph node metastasis. However, gastric cancer is still the second leading cause of cancer deaths in the world, and it is the most prevalent malignancy in Korea. ![]() ![]() There has been a reduced incidence of gastric cancer in western countries over the past few decades. However, its usefulness is reduced in undifferentiated adenocarcinomas. ConclusionsĪI chromoendoscopy is useful in determining the lateral extent of EGCs. However, the border clarification rate for undifferentiated adenocarcinomas did not differ between conventional endoscopy and AI chromoendoscopy (27/43 vs 30/43, respectively, P = 0.494). Compared with conventional endoscopy, AI chromoendoscopy clarified the border in a significantly higher percentage of differentiated adenocarcinomas (74/108 vs 97/108, respectively, P < 0.001). The borders of the lesions were distinct in 66.9% (101/151) with conventional endoscopy and in 84.1% (127/151) with AI chromoendoscopy ( P < 0.001). The border clarification between the lesion and the normal mucosa was classified as distinct or indistinct before and after AI chromoendoscopy. All the lesions were examined by conventional endoscopy and AI chromoendoscopy before ESD or laparoscopic gastrectomy. We prospectively included 151 lesions of 141 patients that had an endoscopic diagnosis of EGC. Therefore, we investigated the diagnostic performance of chromoendoscopy using indigo carmine dye added to acetic acid (AI chromoendoscopy) in delineating differentiated or undifferentiated adenocarcinomas in patients with EGC. ![]() To achieve successful outcomes, it is very important to accurately determine the lateral extent of the tumor. Endoscopic treatments, such as endoscopic submucosal dissection (ESD) and laparoscopic gastrectomy, are increasingly used to treat a subset of patients with early gastric cancer (EGC). ![]()
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