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Taking More Gastroscopy Images Increases the Detection Rate of Clinically Significant Gastric Lesions: Validation of a Systematic Screening Protocol for the Stomach

이자인, 김준성, 김병옥, 허철웅,
소속 상세정보
이자인 ( Lee Ja-In ) - Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Internal Medicine
김준성 ( Kim Joon-Sung ) - Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Internal Medicine
김병옥 ( Kim Byung-Wook ) - Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Internal Medicine
허철웅 ( Huh Cheal-Wung ) - Catholic University College of Medicine Incheon St. Mary’s Hospital Department of Internal Medicine

Abstract


Background/Aims: For systematic screening protocol for the stomach (SSS), 22 gastroscopy images are considered sufficient to avoid blind spots during gastroscopy. The aim of this study was to investigate the relationship between the number of gastroscopy images taken during the gastroscopy procedure and the detection rate of clinically significant gastric lesions (CSGLs).

Materials and Methods: We retrospectively reviewed the data obtained from a cohort of consecutive subjects at a health promotion center. The primary outcome measure was the detection rate of CSGLs per endoscopist, according to the number of gastroscopy images. We also analyzed whether all the CSGLs were detected via SSS.

Results: The mean number of gastroscopy images obtained by eight endoscopists was 27.6±10.5 in 2,912 subjects without CSGLs and without biopsies. Among the 5,970 subjects who underwent gastroscopy by the eight endoscopists, 712 CSGLs were detected in 551 subjects. Fifty-six CSGLs (7.9%) in 55 subjects (10.0%) were not detected during the SSS. Photo-endoscopists who took more images achieved a higher detection rate of CSGLs than those who took fewer images (adjusted OR 2.07, 95% CI 1.41~3.05; P<0.0001).

Conclusions: The modified SSS, which included 22 SSS images, the fundus, and the saddle area, detected significantly more CSGLs. This modified SSS should be validated with further prospective studies.

키워드

Gastric epithelial neoplasia; Gastroscopy; Systematic screening protocol

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