The Korean Journal of Gastroenterology (대한소화기학회지)

The Korean Society of Gastroenterology (대한소화기학회)
권호 표지
DOI QR코드

DOI QR Code

Gastric Cancer Screening and Diagnosis

위암의 스크리닝 및 진단

Choi, Il-Ju
최일주

  • Published : 20090800
⟨ Previous Next ⟩

Abstract

Gastric cancer is the most common cancer in Korea and has overall survival rate of around 50%. Gastric cancer detected in early stage can be cured by endoscopic resection or less invasive surgical treatment and the subsequent prognosis is excellent. National cancer screening program for gastric cancer has been available for several years. The evaluation for efficacy of our screening strategy is strongly needed in terms of mortality reduction and cost-effectiveness. Accurate diagnosis and staging evaluation is important for proper management and prediction of a patient’s prognosis. It is recommended to understand the advantages and limitations of currently available guidelines and diagnostic modalities. The 7th edition of gastric cancer staging system from AJCC may have significant effect on our knowledge and patient management.

Keywords

References

  1. Ministry for Health, Welfare and Family Affairs. Annual Report of the Korea Central Cancer Registry. 2008.
  2. Ministry for Health, Welfare and Family Affairs & National Cancer Center. Cancer Facts and Figures. 2008.
  3. Choi KS, Kwak MS, Lee HY, Jun JK, Hahm MI, Park EC. Screening for gastric cancer in Korea: population-based preferences for endoscopy versus upper gastrointestinal series. Cancer Epidemiol Biomarkers Prev 2009;18:1390-1398. https://doi.org/10.1158/1055-9965.EPI-08-0940
  4. Tsubono Y, Hisamichi S. Screening for gastric cancer in Japan. Gastric Cancer 2000;3:9-18. https://doi.org/10.1007/PL00011692
  5. Kong SH, Park DJ, Lee HJ, et al. Clinicopathologic features of asymptomatic gastric adenocarcinoma patients in Korea. Jpn J Clin Oncol 2004;34:1-7. https://doi.org/10.1093/jjco/hyh009
  6. Nam SY, Choi IJ, Park KW, et al. Effect of repeated endoscopic screening on the incidence and treatment of gastric cancer in health screenees. Eur J Gastroenterol Hepatol 2009;21:855-860. https://doi.org/10.1097/MEG.0b013e328318ed42
  7. Gates TJ. Screening for cancer: evaluating the evidence. Am Fam Physician 2001;63:513-522.
  8. Miyamoto A, Kuriyama S, Nishino Y, et al. Lower risk of death from gastric cancer among participants of gastric cancer screening in Japan: a population-based cohort study. Prev Med 2007;44:12-19. https://doi.org/10.1016/j.ypmed.2006.07.016
  9. Oshima A, Hirata N, Ubukata T, Umeda K, Fujimoto I. Evaluation of a mass screening program for stomach cancer with a case-control study design. Int J Cancer 1986;38:829-833. https://doi.org/10.1002/ijc.2910380608
  10. Fukao A, Tsubono Y, Tsuji I, HIsamichi S, Sugahara N, Takano A. The evaluation of screening for gastric cancer in Miyagi Prefecture, Japan: a population-based case-control study. Int J Cancer 1995;60:45-48. https://doi.org/10.1002/ijc.2910600106
  11. Abe Y, Mitsushima T, Nagatani K, Ikuma H, Minamihara Y. Epidemiological evaluation of the protective effect for dying of stomach cancer by screening programme for stomach cancer with applying a method of case-control study--a study of a efficient screening programme for stomach cancer. Jpn J Gastroenterol 1995;92:836-845.
  12. Hisamichi S, Sugawara N. Mass screening for gastric cancer by X-ray examination. Jpn J Clin Oncol 1984;14:211-223.
  13. Lee KJ, Inoue M, Otani T, Iwasaki M, Sasazuki S, Tsugane S; JPHC Study Group. Gastric cancer screening and subsequent risk of gastric cancer: a large-scale population-based cohort study, with a 13-year follow-up in Japan. Int J Cancer 2006;118:2315-2321. https://doi.org/10.1002/ijc.21664
  14. Oshima A, Hanai A, Fujimoto I. Evaluation of a mass screening program for stomach cancer. Natl Cancer Inst Monogr 1979;53:181-186.
  15. Inaba S, Hirayama H, Nagata C, et al. Evaluation of a screening program on reduction of gastric cancer mortality in Japan: preliminary results from a cohort study. Prev Med 1999;29:102-106. https://doi.org/10.1006/pmed.1999.0507
  16. Mizoue T, Yoshimura T, Tokui N, et al. Japan Collaborative Cohort Study Group. Prospective study of screening for stomach cancer in Japan. Int J Cancer 2003;106:103-107. https://doi.org/10.1002/ijc.11183
  17. Hosokawa O, Miyanaga T, Kaizaki Y, et al. Decreased death from gastric cancer by endoscopic screening: association with a population-based cancer registry. Scand J Gastroenterol 2008;43:1112-1115. https://doi.org/10.1080/00365520802085395
  18. Tashiro A, Sano M, Kinameri K, Fujita K, Takeuchi Y. Comparing mass screening techniques for gastric cancer in Japan. World J Gastroenterol 2006;12:4873-4874.
  19. Mori Y, Arita T, Shimoda K, Yasuda K, Yoshida T, Kitano S. Effect of periodic endoscopy for gastric cancer on early detection and improvement of survival. Gastric Cancer 2001; 4:132-136. https://doi.org/10.1007/PL00011735
  20. Riecken B, Pfeiffer R, Ma JL, et al. No impact of repeated endoscopic screens on gastric cancer mortality in a prospectively followed Chinese population at high risk. Prev Med 2002;34:22-28. https://doi.org/10.1006/pmed.2001.0925
  21. Correa P. Human gastric carcinogenesis: a multistep and multifactorial process--First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention. Cancer Res 1992;52:6735-6740.
  22. Kim JH, Kim HY, Kim NY, et al; Korea H. pylori Study Group, South Korea. Seroepidemiological study of Helicobacter pylori infection in asymptomatic people in South Korea. J Gastroenterol Hepatol 2001;16:969-975. https://doi.org/10.1046/j.1440-1746.2001.02568.x
  23. Wong BC, Lam SK, Wong WM, et al; China Gastric Cancer Study Group. Helicobacter pylori eradication to prevent gastric cancer in a high-risk region of China: a randomized controlled trial. JAMA 2004;291:187-194. https://doi.org/10.1001/jama.291.2.187
  24. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma. 2nd English edition. Gastric Cancer 1998;1:10-24. https://doi.org/10.1007/PL00011681
  25. The Paris endoscopic classification of superficial neoplastic lesions: esophagus, stomach, and colon: November 30 to December 1, 2002. Gastrointest Endosc 2003;58(suppl 6):S3-S43. https://doi.org/10.1016/S0016-5107(03)02159-X
  26. Sobin LH, Wittekind C. UICC: TNM classification of malignant tumours. 6th ed. New York: Wiley-Liss, 2002:65-68
  27. Japenese Research Society for Gastric Cancer. Japenese classification of gastric carcinoma; general rules for the gastric cancer study. 1st ed. Tokyo: Kanehara, 1995:1-104.
  28. Fleming ID, Cooper JS, Henson DE, et al. AJCC cancer staging manual. 5th ed. Philadelphia: Lippincott-Raven, 1997.
  29. Wittekind C. News in the TNM classification. In WHO-CC for gastric cancer. 12th international seminar. 6th general assembly. Seoul, Korea, 1996.
  30. Park DJ, Kong SH, Lee HJ, et al. Subclassification of pT2 gastric adenocarcinoma according to depth of invasion (pT2a vs pT2b) and lymph node status (pN). Surgery 2007;141:757-763. Epub 2007 May 4. https://doi.org/10.1016/j.surg.2007.01.023
  31. Lu Y, Liu C, Zhang R, et al. Prognostic significance of subclassification of pT2 gastric cancer: a retrospective study of 847 patients. Surg Oncol 2008;17:317-322. https://doi.org/10.1016/j.suronc.2008.05.005
  32. Kim JP, Hur YS, Yang HK. Lymph node metastasis as a significant prognostic factor in early gastric cancer: analysis of 1,136 early gastric cancers. Ann Surg Oncol 1995;2:308-313. https://doi.org/10.1007/BF02307062
  33. Shen JY, Kim S, Cheong JH, et al. The impact of total retrieved lymph nodes on staging and survival of patients with pT3 gastric cancer. Cancer 2007;110:745-751. https://doi.org/10.1002/cncr.22837
  34. Marchet A, Mocellin S, Ambrosi A, et al; Italian Research Group for Gastric Cancer (IRGGC). The ratio between metastatic and examined lymph nodes (N ratio) is an independent prognostic factor in gastric cancer regardless of the type of lymphadenectomy: results from an Italian multicentric study in 1853 patients. Ann Surg 2007;245:543-552. https://doi.org/10.1097/01.sla.0000250423.43436.e1
  35. Kim CY, Yang DH. Adjustment of N stages of gastric cancer by the ratio between the metastatic and examined lymph nodes. Ann Surg Oncol 2009;16:1868-1874. https://doi.org/10.1245/s10434-009-0430-8
  36. Lee JM, Jung SE. Imaging diagnosis of gastric cancer: CT scan. J Korean Radiol Soc 2002;46:511-519. https://doi.org/10.3348/jkrs.2002.46.6.511
  37. D'Elia F, Zingarelli A, Palli D, Grani M. Hydro-dynamic CT preoperative staging of gastric cancer: correlation with pathological findings. A prospective study of 107 cases. Eur Radiol 2000;10:1877-1885. https://doi.org/10.1007/s003300000537
  38. Habermann CR, Weiss F, Riecken R, et al. Preoperative staging of gastric adenocarcinoma: comparison of helical CT and endoscopic US. Radiology 2004;230:465-471. https://doi.org/10.1148/radiol.2302020828
  39. Takao M, Fukuda T, Iwanaga S, Hayashi K, Kusano H, Okudaira S. Gastric cancer: evaluation of triphasic spiral CT and radiologic-pathologic correlation. J Comput Assist Tomogr 1998;22:288-294. https://doi.org/10.1097/00004728-199803000-00024
  40. Hundt W, Braunschweig R, Reiser M. Assessment of gastric cancer: value of breathhold technique and two-phase spiral CT. Eur Radiol 1999;9:68-72. https://doi.org/10.1007/s003300050630
  41. Hur J, Park MS, Lee JH, et al. Diagnostic accuracy of multidetector row computed tomography in T- and N staging of gastric cancer with histopathologic correlation. J Comput Assist Tomogr 2006;30:372-377. https://doi.org/10.1097/00004728-200605000-00005
  42. Kim HJ, Kim AY, Oh ST, et al. Gastric cancer staging at multi-detector row CT gastrography: comparison of transverse and volumetric CT scanning. Radiology 2005;236:879-885. https://doi.org/10.1148/radiol.2363041101
  43. Xi WD, Zhao C, Ren GS. Endoscopic ultrasonography in preoperative staging of gastric cancer: determination of tumor invasion depth, nodal involvement and surgical resectability. World J Gastroenterol 2003;9:254-257. https://doi.org/10.3748/wjg.v9.i2.254
  44. Willis S, Truong S, Gribnitz S, Fass J, Schumpelick V. Endoscopic ultrasonography in the preoperative staging of gastric cancer: accuracy and impact on surgical therapy. Surg Endosc 2000;14:951-954. https://doi.org/10.1007/s004640010040
  45. Bhandari S, Shim CS, Kim JH, et al. Usefulness of three-dimensional, multidetector row CT (virtual gastroscopy and multiplanar reconstruction) in the evaluation of gastric cancer: a comparison with conventional endoscopy, EUS, and histopathology. Gastrointest Endosc 2004;59:619-626. https://doi.org/10.1016/S0016-5107(04)00169-5
  46. Ganpathi IS, So JB, Ho KY. Endoscopic ultrasonography for gastric cancer: does it influence treatment? Surg Endosc 2006;20:559-562. https://doi.org/10.1007/s00464-005-0309-0
  47. Bentrem D, Gerdes H, Tang L, Brennan M, Coit D. Clinical correlation of endoscopic ultrasonography with pathologic stage and outcome in patients undergoing curative resection for gastric cancer. Ann Surg Oncol 2007;14:1853-1859. https://doi.org/10.1245/s10434-006-9037-5
  48. Chung IK. Debate on ESD: EUS, PET/CT. Korean J Gastrointest Endosc 2009;38(suppl 1):S177-S183.
  49. Mukai K, Ishida Y, Okajima K, Isozaki H, Morimoto T, Nishiyama S. Usefulness of preoperative FDG PET for detection of gastric cancer. Gastric Cancer 2006;9:192-196. https://doi.org/10.1007/s10120-006-0374-7
  50. Kim SK, Kang KW, Lee JS, et al. Assessment of lymph node metastases using 18F-FDG PET in patients with advanced gastric cancer. Eur J Nucl Med Mol Imaging 2006;33: 148-155. https://doi.org/10.1007/s00259-005-1887-8
  51. Hamilton SR, Aaltonen LA. WHO classification of tumours. Pathology and genetics. Tumours of the digestive system. Lyon: IARC Press, 2000.
  52. Kim WH, Park CK, Kim YB, et al; The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists. A standardized pathology report for gastric cancer. Korean J Pathol 2005;39:106-113.

Cited by

  1. PAK as a therapeutic target in gastric cancer. vol.14, pp.4, 2010, https://doi.org/10.1517/14728221003642019
  2. Characteristics of Gastric Cancer in Korea - with an Emphasis on the Increase of the Early Gastric Cancer (EGC) vol.53, pp.4, 2009, https://doi.org/10.5124/jkma.2010.53.4.283
  3. Screening and Diagnosis of Early Gastric Cancer vol.53, pp.4, 2009, https://doi.org/10.5124/jkma.2010.53.4.290
  4. The Role of Serum Pepsinogen in the Detection of Gastric Cancer vol.4, pp.3, 2009, https://doi.org/10.5009/gnl.2010.4.3.307
  5. Helicobacter pylori infection and current clinical areas of contention vol.26, pp.6, 2010, https://doi.org/10.1097/mog.0b013e32833efede
  6. Changes in clinicopathological features and survival after gastrectomy for gastric cancer over a 20‐year period vol.98, pp.2, 2009, https://doi.org/10.1002/bjs.7310
  7. Long-term Outcome after Endoscopic Treatment for Early Gastric Cancer in Korea vol.12, pp.1, 2009, https://doi.org/10.7704/kjhugr.2012.12.1.1
  8. Comparing Endoscopy and Upper Gastrointestinal X-ray for Gastric Cancer Screening in South Korea: A Cost-utility Analysis vol.13, pp.6, 2009, https://doi.org/10.7314/apjcp.2012.13.6.2721
  9. Safety and Efficacy of Fast-track Surgery in Laparoscopic Distal Gastrectomy for Gastric Cancer: A Randomized Clinical Trial vol.36, pp.12, 2009, https://doi.org/10.1007/s00268-012-1741-7
  10. The Distribution of Endoscopic Gastritis in 25,536 Heath Check-up Subjects in Korea vol.12, pp.4, 2009, https://doi.org/10.7704/kjhugr.2012.12.4.237
  11. Therapeutic Outcomes of Endoscopic Submucosal Dissection in Undifferentiated-type Early Gastric Cancer vol.61, pp.4, 2013, https://doi.org/10.4166/kjg.2013.61.4.196
  12. Factors that affect surgery after endoscopic resection of early gastric cancer patients vol.9, pp.2, 2013, https://doi.org/10.14216/kjco.13021
  13. The value of serum pepsinogen levels for the diagnosis of gastric diseases in Chinese Han people in midsouth China vol.14, pp.None, 2009, https://doi.org/10.1186/1471-230x-14-3
  14. Comparison on the Long Term Outcome between Endoscopic Submucosal Dissection and Surgical Treatment for Undifferentiated Early Gastric Cancer vol.63, pp.2, 2009, https://doi.org/10.4166/kjg.2014.63.2.90
  15. A Case of Metachronous Gastric Cancer and Follicular Lymphoma after Endoscopic Submucosal Dissection for Early Gastric Cancer vol.14, pp.3, 2014, https://doi.org/10.7704/kjhugr.2014.14.3.219
  16. Endoscopic Resection for Undifferentiated Early Gastric Cancer: Focusing on Histologic Discrepancies Between Forceps Biopsy-Based and Endoscopic Resection Specimen-Based Diagnosis vol.59, pp.10, 2009, https://doi.org/10.1007/s10620-014-3196-1
  17. Gastric epithelial dysplasia: characteristics and long-term follow-up results after endoscopic resection according to morphological categorization vol.15, pp.None, 2009, https://doi.org/10.1186/s12876-015-0249-7
  18. Use of a clinical pathway in laparoscopic gastrectomy for gastric cancer vol.21, pp.48, 2015, https://doi.org/10.3748/wjg.v21.i48.13507
  19. Epidemiology and screening of gastric cancer in Korea vol.58, pp.3, 2015, https://doi.org/10.5124/jkma.2015.58.3.183
  20. Recent advances in endoscopic diagnosis and treatment of gastric cancer vol.58, pp.3, 2015, https://doi.org/10.5124/jkma.2015.58.3.191
  21. Time trends of clinicopathologic features and surgical treatment for gastric cancer: Results from 2 high-volume institutions in southern China vol.158, pp.6, 2015, https://doi.org/10.1016/j.surg.2015.04.038
  22. Endoscopic predictors for undifferentiated histology in differentiated gastric neoplasms prior to endoscopic resection vol.30, pp.1, 2009, https://doi.org/10.1007/s00464-015-4165-2
  23. Clinical outcomes of no residual disease in the specimen after endoscopic resection for gastric neoplasms vol.30, pp.2, 2009, https://doi.org/10.1007/s00464-015-4248-0
  24. How Do We Manage Gastric Intestinal Metaplasia? A Survey of Clinical Practice Trends for Gastrointestinal Endoscopists in the United States vol.61, pp.7, 2009, https://doi.org/10.1007/s10620-016-4107-4
  25. Predictive Factors for Pain After Endoscopic Resection of Gastric Tumors vol.61, pp.12, 2009, https://doi.org/10.1007/s10620-016-4325-9
  26. Management of long-term gastric cancer survivors in Korea vol.59, pp.4, 2016, https://doi.org/10.5124/jkma.2016.59.4.256
  27. Quality of Life after Endoscopic Submucosal Dissection for Early Gastric Cancer: A Prospective Multicenter Cohort Study vol.11, pp.1, 2009, https://doi.org/10.5009/gnl15549
  28. Two staging systems for gastrointestinal stromal tumors in the stomach: which is better? vol.17, pp.None, 2017, https://doi.org/10.1186/s12876-017-0705-7
  29. Premalignant Gastric Lesions in Patients Included in National Colorectal Cancer Screening vol.52, pp.1, 2018, https://doi.org/10.1515/raon-2017-0054
  30. Laparoscopy-assisted versus Open D2 Distal Gastrectomy for Advanced Gastric Cancer: Results From a Randomized Phase II Multicenter Clinical Trial (COACT 1001) vol.267, pp.4, 2009, https://doi.org/10.1097/sla.0000000000002168
  31. Increased Risk of Osteoporotic Fracture in Postgastrectomy Gastric Cancer Survivors Compared With Matched Controls: A Nationwide Cohort Study in Korea vol.114, pp.11, 2009, https://doi.org/10.14309/ajg.0000000000000436