Sa1647 Clinical and Endoscopic Characteristics of Gastric Tumors Diagnosed in Serial Screening Endoscopy

Abstract

Sa1647 Clinical and Endoscopic Characteristics of Gastric Tumors Diagnosed in Serial Screening Endoscopy Hyoun Woo Kang*, Hyoung Jung Na, Jae Hak Kim, Jun Kyu Lee, Yun Jeong Lim, Moon Soo Koh, Jin Ho Lee, Eo-Jin Kim Internal Medicine, Dongguk University College of Medicine, Goyang, Republic of Korea; Pathology, Dongguk University College of Medicine, Goyang, Republic of Korea Background: Although biennial upper endoscopy is recommended for screening gastric cancer in Korea, there has been little study on the characteristics of clinical and endoscopic characteristics of gastric tumors diagnosed in screening endoscopy. Material and Methods: We retrospectively reviewed clinical and endoscopic characteristics of gastric cancer or adenoma cases which were diagnosed as during serial screening endoscopy and in which prediagnostic endoscopy was negative from October 2005 to July 2011 at our hospital. Clinical characteristics including mean follow up periods and endoscopic characteristics including location, pathology and prediagnostic endoscopic findings were analyzed. Results: A total of 56 lesions with a histologic diagnosis of gastric epithelial neoplasms (31 early gastric cancers, 4 advanced gastric cancers and 21 gastric adenomas) were included. All cases were consecutively treated with endoscopic submucosal dissection or operation. Mean interval between two endoscopies was 688 day (1501775 day), so we divided into less than 2 years group (n 33) and more than 2 years groups (n 20) by interval between 2 serial examinations. The locations of tumors were antrum 31, body 23 and cardia 2. The initial endoscopic findings were normal 3, gastritis 5, erosion 7, ulcer 7, atrophy 23, and intestinal metaplasia 11. The initial pathologic findings were Helicobacter pylori colonization 68.4% (13/19), neutrophils 52.6 % (10/19), mononuclear cells 84.2% (16/19), atrophy 94.7% (18/19), and intestinal metaplasia 68.8%(11/19). Among 53 cases(except 3 cases due to follow up loss), 3 patients were not cured because of metastasis at the time of diagnosis or recurrence during follow up period. In less than 2 years group, all patients were cured, but in more than 2 years group, 2 patients had distant metastasis at the time of diagnosis and 1 patient had recurrence during follow up period. It showed the statistical difference (p 0.022). Conclusions: In conclusions, findings of atrophy during screening upper endoscopy, especially in location of antrum, should necessitate precautious follow up endoscopy. Screening endoscopy for cancer detection may be done within every 2 years.