Huh Jung, Kim Su Hwan, Kim Kwang Woo, Jeong Yun Jin, Oh Dong Jun, Jang Dong Kee, Jang Heejoon, Jeong Ji Bong, Kim Ji Won, Lee Kook Lae, Kang Hyoun Woo
Department of Internal Medicine, Division of Gastroenterology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul.
Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
Saudi J Gastroenterol. 2025 Jul 1;31(4):219-226. doi: 10.4103/sjg.sjg_31_25. Epub 2025 Jul 21.
Although biennial upper gastrointestinal endoscopy is recommended for gastric cancer screening in Korea, data regarding the endoscopic characteristics associated with the diagnosis of gastric neoplasms in serial endoscopic screening are limited. We aimed to evaluate the index endoscopic characteristics associated with the diagnosis of gastric neoplasms and adequate gastric cancer screening interval.
We retrospectively reviewed cases of the patients diagnosed with gastric neoplasms, who showed no evidence of gastric neoplasms on index endoscopy between October 2005 and December 2022. The indices of endoscopic characteristics were analyzed. Patients were stratified according to the interval between endoscopic examinations (≤1, 1-2, 2-3, and >3 years), and the proportion of adenoma, early gastric cancer (EGC) and advanced gastric cancer (AGC) was analyzed across groups.
A total of 331 lesions with histological diagnoses of gastric neoplasms (167 adenomas, 138 EGCs, and 26 AGCs) were included. The initial baseline endoscopic findings were as follows: normal, 22 (6.7%); gastritis, 16 (4.8%); erosion, 65 (19.6%); ulcers, 19 (5.8%); atrophy, 104 (31.4%); and intestinal metaplasia, 105 (31.7%). The proportion of AGC increased with longer surveillance intervals: 0% at ≤1 year (median: 0.76 years, interquartile range [IQR]: 0.38), 3.1% at 1-2 years (1.59; 0.57), 6.7% at 2-3 years (2.37; 0.51), and 20.0% at >3 years (4.18; 1.53). Conversely, adenoma were most frequently detected within 1 year, comprising 63.6% ( P < 0.05).
Cautious follow-up endoscopy may be necessary for patients demonstrating endoscopic findings of atrophy and intestinal metaplasia. Shorter surveillance intervals enable early detection of gastric neoplasia and may prevent progression to advanced cancer.
尽管韩国推荐每两年进行一次上消化道内镜检查用于胃癌筛查，但关于连续内镜筛查中与胃肿瘤诊断相关的内镜特征的数据有限。我们旨在评估与胃肿瘤诊断相关的指标性内镜特征以及合适的胃癌筛查间隔。
我们回顾性分析了2005年10月至2022年12月期间在初次内镜检查时未发现胃肿瘤证据但随后被诊断为胃肿瘤的患者病例。分析内镜特征指标。根据内镜检查间隔（≤1年、1 - 2年、2 - 3年和>3年）对患者进行分层，并分析各层中腺瘤、早期胃癌（EGC）和进展期胃癌（AGC）的比例。
共纳入331例经组织学诊断为胃肿瘤的病变（167例腺瘤、138例EGC和26例AGC）。初次基线内镜检查结果如下：正常，22例（6.7%）；胃炎，16例（4.8%）；糜烂，65例（19.6%）；溃疡，19例（5.8%）；萎缩，104例（31.4%）；肠化生，105例（31.7%）。AGC的比例随着监测间隔延长而增加：≤1年时为0%（中位数：0.76年，四分位间距[IQR]：0.38），1 - 2年时为3.1%（1.59；0.57），2 - 3年时为6.7%（2.37；0.51），>3年时为20.0%（4.18；1.53）。相反，腺瘤最常在1年内被检测到，占63.6%（P < 0.05）。
对于表现出萎缩和肠化生内镜表现的患者，可能需要谨慎进行随访内镜检查。较短的监测间隔能够早期发现胃肿瘤，并可能预防进展为进展期癌症。
