Endoscopic Diagnosis of Early Gastric Cancer and High-Risk Gastritis
Hidekazu Suzuki, Masaya Sano, Toshihiro Nishizawa, Osamu Toyoshima
Abstract
Many differentiated and undifferentiated gastric cancers are associated with Helicobacter pylori infection. Therefore, as a primary prevention method, the early diagnosis of H. pylori gastritis and eradication of these bacteria can prevent gastric cancer. As a secondary prevention method, the early diagnosis of gastric cancer and endoscopic treatment can also contribute to reducing overall mortality. Gastric mucosal atrophy and intestinal metaplasia are important findings in patients with H. pylori gastritis. The accurate diagnosis of other characteristic findings is also important to comprehensively assess gastric cancer risk. The identification of precancerous lesions and early gastric cancer by evaluating endoscopic gastric cancer risk scores, based on the Kyoto classification of gastritis, is similarly important. Recently, endoscopic image evaluation systems equipped with artificial intelligence have been developed to complement the diagnostic abilities of individual endoscopists and reduce interobserver variability; future developments in this area are highly anticipated.