Endoscopy 2020; 52(S 01): S208
DOI: 10.1055/s-0040-1704648
ESGE Days 2020 ePoster Podium presentations
Saturday, April 25, 2020 09:30 – 10:00 Upper GI: Endoscopic diagnosis 2 ePoster Podium 6
© Georg Thieme Verlag KG Stuttgart · New York

IT IS SO USEFUL TO KNOW GASTRIC CANCER RISK AT GASTRIC ENTRANCE (CARDIA) WITH THE PRESENCE OF AN EASY SIMPLE SIGN

T Yamasaki
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
,
Y Kinoshita
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
,
Y Akita
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
,
H Miyashita
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
,
Y Maruyama
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
,
R Miyazaki
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
,
T Sakurai
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
,
M Mitsunaga
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
,
M Saruta
The Jikei University, School of Medicine, Division of Gastroentelogy and Hepatology, Department of Internal Medicine, Tokyo, Japan
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Publikationsverlauf

Publikationsdatum:
23. April 2020 (online)

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    Aims We have confused with various newly endoscopic findings (patchy redness and map-like redness etc.) after H.pylori（HP）eradication. On this time, we have found out a new other ultimate useful finding showing HP related gastritis at gastric cardia including present and post HP infection. Our aim of this study is to elucidate the possibility of judgement with only this cardiac endoscopic view about presence or absence with HP infection.

    Methods We have found out so useful and specific cardiac image (Whale Shark Sign: WSS) closely related to HP infection six years ago. We have examined the presence of WSS on 5, 423 cases that have been able to overview on their endoscopic profiles. The 4,939 cases their serum HP antibody titers were measured from Jan. 2012 to Oct. 2019. A total of 3,837 patients (HP positive) were enrolled.

    Results Mean age of patients was 51.2 years old. The positive predictive value (PPV) of WSS was surprisingly high (98.9%). According to this high PPV, we can think WSS positive cases are high risk of gastric cancer. This WSS mean that the presence of irregular gastric mucosal surface pattern and the presence of lymphoid hyperplasia, that showing HP infectious stomach. This lymphoid hyperplasia at gastric cardia were recognized small round whitish nodules on white light endoscopy. And this was more emphasized with image-enhanced endoscopy (Narrow Band Imaging: NBI), it looks like Whale Shark. It is so useful to know gastric cancer risk at gastric entrance (cardia) with the presence of an easy simple sign. This WSS sign is so simple and easy for every gastroenterologist.

    Conclusions We have been able to judge the presence of HP infection with only cardiac endoscopic image (WSS). Since this sign is very easy and simple, everyone will be able to judge the presence of HP infection and gastric cancer risk.


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