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White globe appearance is an endoscopic predictive factor for synchronous multiple gastric cancer
Teppei Masunaga1, Naohiro Yoshida1, Shinichiro Akiyama1
1Department of Gastroenterology (Teppei Masunaga, Naohiro Yoshida, Shinichiro Akiyama, Gen Sugiyama, Hirokazu Hirai, Saori Miyajima, Shigenori Wakita, Yosuke Kito, Hiroyoshi Nakanishi, Kunihiro Tsuji, Kazuhiro Matsunaga, Shigetsugu Tsuji, Kenichi Takemura, Hisashi Doyama).
Annals of Gastroenterology
|March 3, 2021
Summary
White globe appearance (WGA) may predict synchronous multiple gastric cancer (SMGC). Patients with WGA-positive gastric cancer require careful examination for potential SMGC diagnosis.
Area of Science:
- Gastroenterology
- Oncology
- Endoscopic Imaging
Background:
- White globe appearance (WGA) is a distinct lesion identified via magnifying endoscopy with narrow-band imaging.
- The association between WGA and synchronous multiple gastric cancer (SMGC) is not well-established.
Purpose of the Study:
- To investigate the potential of WGA as a predictive factor for SMGC.
- To compare the prevalence of WGA in patients with and without SMGC.
Main Methods:
- Retrospective analysis of patients undergoing endoscopic submucosal dissection for gastric cancer (GC).
- Classification of patients into SMGC-positive (>2 GCs) and SMGC-negative groups.
- Univariate and multivariate analyses assessing WGA, age, sex, atrophy, and H. pylori status.
Main Results:
- WGA-positive classification was significantly associated with SMGC in both univariate (50% vs. 23%, P=0.008) and multivariate analyses (OR 2.78, P=0.02).
- Male sex was associated in univariate analysis but not independently predictive.
- Age, severe atrophy, and H. pylori status were not significant factors for SMGC.
Conclusions:
- WGA may serve as a potential predictive marker for synchronous multiple gastric cancer.
- Gastric cancers exhibiting WGA warrant meticulous examination to rule out synchronous lesions.
