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Systematic Endoscopic Approach to Early Gastric Cancer in Clinical Practice.
Gut and Liver ( IF 3.4 ) Pub Date : 2021-04-06 , DOI: 10.5009/gnl20318
Gwang Ha Kim 1
Affiliation  

Early gastric cancers (EGCs) are defined as gastric cancers confined to the mucosa or submucosa, regardless of regional lymph node metastasis. The proportion of EGCs has been increasing due to the increase in screening endoscopy for gastric cancers; therefore, the paradigm shift from surgical resection to endoscopic resection as a treatment modality for selected EGCs is accelerating. For successful endoscopic resection of EGCs, it is important to detect EGCs at an early stage and to accurately predict the histological type, depth of invasion, and horizontal margins of the tumor. The diagnostic process of EGCs can be divided into three steps: presence diagnosis, qualitative diagnosis, and quantitative diagnosis. The presence diagnosis of EGCs is mainly based on two endoscopic findings: a well-demarcated lesion and irregularity in the color/surface pattern. Qualitative diagnosis refers to the prediction of histological type, which is mainly possible based on the macroscopic shape and color of the lesion. Quantitative diagnosis of EGCs consists of predicting the depth of invasion by detailed examination of the macroscopic morphology and determining horizontal margins using chromoendoscopy. Although advanced diagnostic modalities, such as endosonography or magnifying endoscopy, are helpful for the qualitative and quantitative diagnosis of EGCs, these modalities are not available in most hospitals. Therefore, it is still very important to evaluate EGCs systematically during conventional endoscopy for successful endoscopic treatment.

中文翻译:

临床实践中早期胃癌的系统内窥镜方法。

早期胃癌(EGCs)被定义为局限于黏膜或黏膜下层的胃癌,与区域淋巴结转移无关。由于胃癌筛查内镜检查的增加,EGCs的比例一直在增加;因此,从手术切除到内窥镜切除的范式转变作为选定 EGC 的治疗方式正在加速。为了成功地内镜下切除 EGC,重要的是早期检测 EGC 并准确预测肿瘤的组织学类型、浸润深度和水平边缘。EGCs的诊断过程可分为存在诊断、定性诊断和定量诊断三个步骤。EGC 的存在诊断主要基于两个内镜检查结果:界限清楚的病变和颜色/表面图案的不规则性。定性诊断是指组织学类型的预测,主要根据病灶的宏观形状和颜色进行预测。EGC 的定量诊断包括通过详细检查宏观形态和使用色素内镜确定水平边缘来预测浸润深度。尽管内窥镜检查或放大内窥镜检查等先进的诊断方法有助于 EGC 的定性和定量诊断,但大多数医院并不提供这些方法。因此,在常规内窥镜检查过程中系统地评估EGCs对于成功的内镜治疗仍然非常重要。这主要是根据病变的宏观形状和颜色可能的。EGC 的定量诊断包括通过详细检查宏观形态和使用色素内镜确定水平边缘来预测浸润深度。尽管内窥镜检查或放大内窥镜检查等先进的诊断方法有助于 EGC 的定性和定量诊断,但大多数医院并不提供这些方法。因此,在常规内窥镜检查过程中系统地评估EGCs对于成功的内镜治疗仍然非常重要。这主要是根据病变的宏观形状和颜色可能的。EGC 的定量诊断包括通过详细检查宏观形态和使用色素内镜确定水平边缘来预测浸润深度。尽管内窥镜检查或放大内窥镜检查等先进的诊断方法有助于 EGC 的定性和定量诊断,但大多数医院并不提供这些方法。因此,在常规内窥镜检查过程中系统地评估EGCs对于成功的内镜治疗仍然非常重要。尽管内窥镜检查或放大内窥镜检查等先进的诊断方法有助于 EGC 的定性和定量诊断,但大多数医院并不提供这些方法。因此,在常规内窥镜检查过程中系统地评估EGCs对于成功的内镜治疗仍然非常重要。尽管内窥镜检查或放大内窥镜检查等先进的诊断方法有助于 EGC 的定性和定量诊断,但大多数医院并不提供这些方法。因此,在常规内窥镜检查过程中系统地评估EGCs对于成功的内镜治疗仍然非常重要。
更新日期:2021-04-03
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