Gotoda Takuji, Uedo Noriya, Yoshinaga Shigetaka, Tanuma Tokuma, Morita Yoshinori, Doyama Hisashi, Aso Akira, Hirasawa Toshiaki, Yano Tomonori, Uchita Kunihisa, Ho Shiaw-Hooi, Hsieh Ping-Hsin
Division of Gastroenterology and Hepatology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan.
Department of Gastrointestinal Oncology, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, Japan.
Dig Endosc. 2016 Apr;28 Suppl 1:2-15. doi: 10.1111/den.12623.
Endoscopic diagnosis of gastrointestinal tumors consists of the following processes: (i) detection; (ii) differential diagnosis; and (iii) quantitative diagnosis (size and depth) of a lesion. Although detection is the first step to make a diagnosis of the tumor, the lesion can be overlooked if an endoscopist has no knowledge of what an early-stage 'superficial lesion' looks like. In recent years, image-enhanced endoscopy has become common, but white-light endoscopy (WLI) is still the first step for detection and characterization of lesions in general clinical practice. Settings and practice of routine esophagogastroduodenoscopy (EGD) such as use of antispasmodics, number of endoscopic images taken, and observational procedure are customarily decided in each facility in each country and are not well standardized. Therefore, in the present article, we attempted to outline currently available evidence and actual Japanese practice on gastric cancer screening using WLI, and provide tips for detecting EGC during routine EGD which could become the basis of future research.
（i）检测；（ii）鉴别诊断；以及（iii）病变的定量诊断（大小和深度）。尽管检测是肿瘤诊断的第一步，但如果内镜医师不了解早期“浅表病变”的样子，病变可能会被忽视。近年来，图像增强内镜已变得普遍，但在一般临床实践中，白光内镜检查（WLI）仍然是病变检测和特征描述的第一步。常规食管胃十二指肠镜检查（EGD）的设置和操作，如解痉药的使用、拍摄的内镜图像数量以及观察程序，通常由每个国家的每个机构自行决定，且标准化程度不高。因此，在本文中，我们试图概述目前关于使用WLI进行胃癌筛查的现有证据和日本的实际做法，并提供在常规EGD期间检测早期胃癌的技巧，这可能成为未来研究的基础。
