Image Enhanced Endoscopy for the Diagnosis of Early Gastric Cancer Kenshi Yao 1 , Takashi Nagahama 1 , Toshiharu Ueki 2 , Akinori Iwashita 3 1Department of Endoscopy, Fukuoka University Chikushi Hospital, Chikushino, Japan 2Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan 3Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan Keyword: 画像強調内視鏡 , 拡大内視鏡 , 胃癌 , 診断体系 , 限界 pp.611-620
Published Date 2018/5/24
DOI https://doi.org/10.11477/mf.1403201357
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 In order to demonstrate basics for the diagnosis of early gastric cancer using magnifying endoscopy with image enhanced technique, we addressed principles and clinical applications of VS(vessel plus surface)classification system and magnifying endoscopy simple diagnostic algorithm for early gastric cancer(MESDA-G). The representative clinical applications are (1)differential diagnosis between cancer and non-cancer in screening endoscopy and (2)determining the horizontal extent of early gastric cancer as preoperative diagnosis. Usefulness for both applications has been proven to be useful with high-evidence level. However, undifferentiated type of early gastric cancer which shows pale superficial flat or depressed appearance is one of the limitations. Considering the limitations, we have proposed strategies for the proper management in the diagnostic process. On the other hand, regarding differentiated type of early gastric cancer, magnifying endoscopy with image enhanced technique is remarkably useful even for flat or minute cancer. After we are aware of the limitations, proper diagnostic strategies should be applied in clinical practice.

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