Foundation for Detection of Early Gastric Carcinoma

Foundation for Detection of Early Gastric Carcinoma

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Nishigori T.,Komagome Hospital | Miura A.,Komagome Hospital | Kato T.,Komagome Hospital | Ryotokuji T.,Komagome Hospital | And 9 more authors.
Esophagus | Year: 2013

A 70-year-old man was diagnosed with a thoracic esophageal squamous cell carcinoma invading the muscularis mucosa without lymph node or distant metastases in June 2003. Endoscopic mucosal resection was conducted. Histological examination showed squamous cell carcinoma invading the deep mucosal layer without lymphatic permeation. In April 2006, a chest CT scan revealed a metastasis to the right recurrent laryngeal nerve chain (106recR) lymph node, and chemoradiotherapy and chemotherapies were performed but were not very effective. He died of esophagobronchial fistula in October 2007. We reexamined this case in detail, and a deeper cut of the block revealed positive lymph vessel invasion and droplet infiltrations. We were initially unable to identify lymphatic permeation but specific findings were determined, such as high degrees of cellular atypia, downward extension of irregular epithelial processes, and irregular margins of cancer alveoli. Extreme caution is required for treating patients with these morphological changes. © 2012 The Japan Esophageal Society and Springer Japan.


Yamazato T.,Tokyo Metropolitan Cancer Detection Center | Yamazato T.,Imari Arita Kyouritsu Hospital | Oyama T.,Saku Central Hospital | Yoshida T.,Foundation for Detection of Early Gastric Carcinoma | And 3 more authors.
Internal Medicine | Year: 2012

Objective Early detection of gastric cancer by screening endoscopy facilitates endoscopic treatment in place of open surgery. The aim of this study was to evaluate whether 2 years intensive training improved the detection of gastric cancer by screening endoscopy. Methods An endoscopist who had trained for 6 years as a general physician, performed screening endoscopy at Imari Arita Kyoritsu Hospital before (group I) and after (group II) intensive training in the diagnosis of early gastric cancer in consecutive patients. Results Background characteristics, including age (61.6 vs. 62.2 years) and sex, did not differ between the groups. Before training, 10 gastric neoplasms were detected in 937 patients in group I: four early gastric cancers, one gastric adenoma, and five advanced gastric cancer. After training, 36 gastric neoplasms were detected in 937 patients in group II: 18 early gastric cancers, 11 gastric adenoma, five advanced gastric cancer, and one each of gastric carcinoid and malignant lymphoma. The detection rate for early gastric cancer was significantly improved by training [group I: 4/937 (0.4%) vs. group II: 18/937 (1.9%)], although the detection rate for advanced gastric cancer did not differ before and after training. The proportion of early gastric cancer + adenoma to advanced cancer was higher in group II (5/5 vs. 29/5 in group I). Conclusion Intensive training in upper gastrointestinal endoscopy screening dramatically improved the detection rate for early gastric cancer, although the detection rate for advanced gastric cancer was not affected. © 2012 The Japanese Society of Internal Medicine.


PubMed | Foundation for Detection of Early Gastric Carcinoma, Hyogo College of Medicine, Japan National Cardiovascular Center Research Institute, Takeda Pharmaceutical and Osaka University
Type: Journal Article | Journal: Alimentary pharmacology & therapeutics | Year: 2016

Vonoprazan is a new potassium-competitive acid blocker for treatment of acid-related diseases.To conduct two randomised-controlled trials, to evaluate the non-inferiority of vonoprazan vs. lansoprazole, a proton pump inhibitor, for treatment of gastric ulcer (GU) or duodenal ulcer (DU).Patients aged 20 years with 1 endoscopically-confirmed GU or DU (5 mm white coating) were randomised 1:1 using double-dummy blinding to receive lansoprazole (30 mg) or vonoprazan (20 mg) for 8 (GU study) or 6 (DU study) weeks. The primary endpoint was the proportion of patients with endoscopically confirmed healed GU or DU.For GU, 93.5% (216/231) of vonoprazan-treated patients and 93.8% (211/225) of lansoprazole-treated patients achieved healed GU; non-inferiority of vonoprazan to lansoprazole was confirmed [difference = -0.3% (95% CI -4.750, 4.208); P = 0.0011]. For DU, 95.5% (170/178) of vonoprazan-treated patients and 98.3% (177/180) of lansoprazole-treated patients achieved healed DU; non-inferiority to lansoprazole was not confirmed [difference = -2.8% (95% CI -6.400, 0.745); P = 0.0654]. The incidences of treatment-emergent adverse events were slightly lower for GU and slightly higher for DU with vonoprazan than with lansoprazole. There was one death (subarachnoid haemorrhage) in the vonoprazan group (DU). The possibility of a relationship between this unexpected patient death and the study drug could not be ruled out. In both studies, increases in serum gastrin levels were greater in vonoprazan-treated vs. lansoprazole-treated patients; levels returned to baseline after treatment in both groups.Vonoprazan 20 mg has a similar tolerability profile to lansoprazole 30 mg and is non-inferior with respect to GU healing and has similar efficacy for DU healing.


Sakaki N.,Foundation for Detection of Early Gastric Carcinoma | Ashida K.,Osaka Saiseikai Nakatsu Hospital | Mizokami Y.,University of Tsukuba | Chiba T.,Kyoto University | And 5 more authors.
Hepato-Gastroenterology | Year: 2013

Background/Aims: To compare the endoscopic features of LDA-induced ulcers developing during secondary prophylaxis with lansoprazole (LPZ) and gefarnate (GFN). Methodology: All ulcers that had developed during prophylaxis with LPZ (15mg once daily) and GFN (50mg twice daily) in a prospective, randomized, double-blind trial, were reviewed and compared by a panel of expert endoscopists, based on endoscopic images available from the trial, to provide evidence for efficacy of LPZ versus GFN in secondary prophylaxis in patients with endoscopically confirmed ulcer scars. Results: A total of 6 and 53 patients had developed gastric or duodenal ulcers during prophylaxis with LPZ and GFN, respectively. Six gastric ulcers seen in those given LPZ were "small" and "shallow", while, of the 38 gastric ulcers seen those given GFN, 44.7% and 55.3% were "medium" or "large" and "small", respectively. Ulcers associated with blood coagula were seen only in those given GFN. Duodenal ulcers developed in 15 and 0 patients given GFN and LPZ, respectively. Conclusions: The ulcers developing during prophylaxis with GFN and LPZ varied in their features. The study findings may be useful when devising a strategy for prophylaxis of ulcers in high-risk patients receiving LDA therapy in a routine clinical setting. © H.G.E. Update Medical Publishing S.A.


Honda M.,Komagome Hospital | Izumi Y.,Komagome Hospital | Miura A.,Komagome Hospital | Kato T.,Komagome Hospital | And 7 more authors.
Esophagus | Year: 2010

"Linitis plastica" refers to a histological characterization of diffusely infiltrating, poorly differentiated adenocarcinoma. Linitis plastica-type esophageal adenocarcinoma is extremely rare: this is thought to be only the sixth case report of linitis plastica involving the esophagus. A 60-year-old man was referred to our hospital after repeated endoscopic examinations over the course of a few months. Because he complained of dysphagia, upper endoscopy was performed, revealing stenosis with a few mucosal changes of the lower esophagus. Gastroesophageal reflux disease was initially diagnosed, but biopsy revealed adenocarcinoma. At the time of operation, peritoneal metastasis was noted. Macroscopically, the lesion was diffusely infiltrating, almost completely covered with normal squamous epithelium that showed positive staining with iodine. Pathological examination showed poorly differentiated adenocarcinoma. Despite the poor prognosis, the patient survived a comparatively long 18 months following esophagectomy with oral chemotherapy using S-1. © Japan Esophageal Society and Springer 2010.


Nakashima H.,Foundation for Detection of Early Gastric Carcinoma
Nihon rinsho. Japanese journal of clinical medicine | Year: 2012

This article describes a method of gastrographic examination and its use in diagnosis of gastric cancer. Gastrography includes four examination methods: barium filled, mucosal relief, compression, and double contrast studies. Diagnosis by gastrography is based on the histogenesis of gastric cancer. Depressive undifferentiated type cancer, which arises from the fundic gland mucosa, shows a clear depressed border between the carcinoma and normal mucosa. The surface of the cancer also shows granular changes in regenerative mucosa. Depressive differentiated type cancer, which develops from intestinal metaplastic mucosa, has a smooth mucosal surface and shows depression of the cancer accompanied with slightly elevated margins. Most elevated type gastric cancers are intramucosal cancers of differentiated type carcinoma. However, cancers showing elevation of more than 3cm would be predicted to show invasive potential by conventional statistical gastric cancer studies.


Nakashima H.,Foundation for Detection of Early Gastric Carcinoma | Nagahama R.,Foundation for Detection of Early Gastric Carcinoma | Yamamoto T.,Foundation for Detection of Early Gastric Carcinoma | Ohkura Y.,Kyorin University
Gastric Cancer | Year: 2010

Background. Gastroendoscopy (GS) has recently been applied in mass screening for gastric cancer, instead of X-ray examination, to improve the quality of the screening. However, as there are currently limitations in the application of endoscopy in all types of screening for gastric cancer, patients must be selected for mass screening by endoscopy. We investigated how to select individuals for endoscopic examination of gastric cancer screening and the effectiveness of X-ray primary screening before endoscopy. Methods. All 7942 patients who underwent upper endoscopy for gastric cancer screening at our hospital between April 2005 and March 2008 were divided into two groups: An X-ray screening group (2782 subjects, endoscopy following primary X-ray screening), and a GS direct group (5160 subjects, endoscopy only). Results. Thirty-seven carcinomas were detected among the 2782 subjects in the X-ray screening group undergoing endoscopy, representing a cancer detection rate of 1.33%. In the GS direct group, 23 carcinomas were detected in the 5160 subjects undergoing endoscopy, representing a cancer detection rate of 0.45%. However, our results suggested that the gastric cancer detection rate by endoscopy was three times higher when it was performed following X-ray screening. Conclusion. There are various confl icting demands for future screening. Our results suggest that it is appropriate to perform an initial X-ray examination followed by endoscopy in prospective screening for gastric cancer. © 2010 by International and Japanese Gastric Cancer Associations.


Nakashima H.,Foundation for Detection of Early Gastric Carcinoma | Nagahama R.,Foundation for Detection of Early Gastric Carcinoma | Yoshida M.,Foundation for Detection of Early Gastric Carcinoma
Japanese Journal of Cancer and Chemotherapy | Year: 2012

Recently, endoscopic examinations have played a major role in the diagnosis and treatment in the field of gastroenterology. It is considered that endoscopy would be an important examination for cancer screening of the esophagus and the stomach. However, endoscopic services for cancer screening are in short supply. Furthermore, we have to take the complications and poor economic benefits of endoscopy in to consideration when we apply it as a practical cancer screening system. Thus, an effective primary screening system must be provided for the endoscopic screening of cancer of the esophagus and the stomach. People with a defect in aldehyde dehydrogenase-2 (ALDH2) should be distinguished by their facial flushing in drinking and for their high risks of esophageal cancer. In cases with gastric cancer screening by endoscopy, an x-ray study is expected to be a primary screening because of its efficacy. It already has been recommended for population-based screening in Japanese guidelines for gastric cancer screening. In cases with opportunistic screening of gastric cancer, patients should be allowed to choose from several studies such as the x-ray study, direct endoscopy, and the so-called high risk screening of gastric cancer for estimating risks and planning of screening for gastric cancer.


PubMed | Foundation for Detection of Early Gastric Carcinoma
Type: Journal Article | Journal: Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association | Year: 2010

Gastroendoscopy (GS) has recently been applied in mass screening for gastric cancer, instead of X-ray examination, to improve the quality of the screening. However, as there are currently limitations in the application of endoscopy in all types of screening for gastric cancer, patients must be selected for mass screening by endoscopy. We investigated how to select individuals for endoscopic examination of gastric cancer screening and the effectiveness of X-ray primary screening before endoscopy.All 7942 patients who underwent upper endoscopy for gastric cancer screening at our hospital between April 2005 and March 2008 were divided into two groups: an X-ray screening group (2782 subjects, endoscopy following primary X-ray screening), and a GS direct group (5160 subjects, endoscopy only).Thirty-seven carcinomas were detected among the 2782 subjects in the X-ray screening group undergoing endoscopy, representing a cancer detection rate of 1.33%. In the GS direct group, 23 carcinomas were detected in the 5160 subjects undergoing endoscopy, representing a cancer detection rate of 0.45%. However, our results suggested that the gastric cancer detection rate by endoscopy was three times higher when it was performed following X-ray screening.There are various conflicting demands for future screening. Our results suggest that it is appropriate to perform an initial X-ray examination followed by endoscopy in prospective screening for gastric cancer.


PubMed | Foundation for Detection of Early Gastric Carcinoma
Type: Journal Article | Journal: Gan to kagaku ryoho. Cancer & chemotherapy | Year: 2012

Recently, endoscopic examinations have played a major role in the diagnosis and treatment in the field of gastroenterology. It is considered that endoscopy would be an important examination for cancer screening of the esophagus and the stomach. However, endoscopic services for cancer screening are in short supply. Furthermore, we have to take the complications and poor economic benefits of endoscopy in to consideration when we apply it as a practical cancer screening system. Thus, an effective primary screening system must be provided for the endoscopic screening of cancer of the esophagus and the stomach. People with a defect in aldehyde dehydrogenase-2(ALDH2)should be distinguished by their facial flushing in drinking and for their high risks of esophageal cancer. In cases with gastric cancer screening by endoscopy, an x-ray study is expected to be a primary screening because of its efficacy. It already has been recommended for population-based screening in Japanese guidelines for gastric cancer screening. In cases with opportunistic screening of gastric cancer, patients should be allowed to choose from several studies such as the x-ray study, direct endoscopy, and the so-called high risk screening of gastric cancer for estimating risks and planning of screening for gastric cancer.

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