Abstract
Although the recent development and widespread use of image-enhanced endoscopy and magnifying endoscopy have improved endoscopic diagnosis of gastric cancer, it is somewhat complicated, requires a higher level of expertise, and is still subjective. Photodynamic endoscopic diagnosis (PDED) is based on the fluorescence of photosensitizers that accumulate in tumors, which enables objective evaluation independent of the endoscopist’s experience, and is useful for tumor detection. The objective of this work was to perform a narrative review of PDED for gastric tumors and to introduce our approach to PDED in gastric tumors in our hospital. In our review there have been case reports of PDED for gastric cancer, but its usefulness has not been established because no prospective studies evaluating its usefulness have been performed. In our previous study, 85.7% (42/49) of gastric tumors exhibited fluorescence in PDED. PDED may be useful in the diagnosis of early gastric cancer. Our previous studies were pilot studies in cancer patients; therefore, future prospective studies are required to verify the usefulness of PDED.
Highlights
According to the latest cancer statistics, 1.09 million new cases of gastric cancer are diagnosed annually worldwide, and 770,000 persons die from gastric cancer annually
A multicenter study conducted in Japan [13] reported that narrow band imaging (NBI) did not increase the detection rate of early gastric cancer compared to white light observation
5-ALA-Photodynamic diagnosis (PDD) is used as an adjunct diagnosis during transurethral resection of bladder tumor (TURBT) for non-muscle layer invasive bladder cancer, and some meta-analyses have reported that the recurrence rate is reduced compared with white light observation [46,47,48]
Summary
According to the latest cancer statistics, 1.09 million new cases of gastric cancer are diagnosed annually worldwide, and 770,000 persons die from gastric cancer annually. Gastric cancer has a 5-year survival rate of over 95% if detected at an early stage [2]. With the recent development and widespread use of endoscopic treatment techniques such as endoscopic submucosal dissection, endoscopic resection can be performed with little or no loss of gastric function if the lesion is detected early enough [3,4]. The recent development and widespread use of image-enhanced endoscopy, such as narrow band imaging (NBI), blue light imaging (BLI), and magnifying endoscopy, have dramatically improved endoscopic diagnosis of gastric cancer [5,6,7,8,9]. A multicenter study conducted in Japan [13] reported that NBI did not increase the detection rate of early gastric cancer compared to white light observation. We will introduce our approach to PDED in gastric tumors in our hospital
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