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17-06-2024 | Esophagogastroduodenoscopy

Risk factors of missed early gastric cancer in endoscopic resected population: a retrospective, case–control study

Authors: Zhenyu Zhang, Ningjing Gao, Kun Liu, Muhan Ni, Xiang Zhang, Peng Yan, Min Chen, Xiaotan Dou, Huimin Guo, Tian Yang, Xiwei Ding, Guifang Xu, Dehua Tang, Lei Wang, Xiaoping Zou

Published in: Surgical Endoscopy

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Abstract

Background

Missed early gastric cancer (MEGC) is prevalent during esophagogastroduodenoscopy (EGD), which is the first-line recommended strategy for detecting early gastric cancer (EGC). Hence, we explored the risk factors for MEGC and different types of MEGC, based on the endoscopic resected population.

Methods

This retrospective, case–control study was conducted at Nanjing Drum Tower Hospital (NJDTH). We included patients who were diagnosed with EGC during screening EGD, underwent endoscopic resection, and were confirmed by postoperative pathology at the NJDTH from January 2014 to December 2021, and classified them into different types according to the different root causes of misses. Univariable, multivariable, subgroup and propensity score analyses were used to explore the risk factors for MEGC and different types of MEGC.

Results

A total of 447 patients, comprising 345 with initially detected early gastric cancer (IDEGC) and 102 with MEGC, were included in this study. Larger size (≥ 1 cm) (OR 0.45, 95% CI 0.27–0.74, P = 0.002) and invasion depth of submucosa (OR 0.26, 95% CI 0.10–0.69, P = 0.007) were negatively associated with MEGC. Use of sedation (OR 0.32, 95% CI 0.20–0.52, P < 0.001) and longer observation time (OR 0.60, 95% CI 0.37–0.96, P = 0.034) exhibited protective effect on MEGC.

Conclusions

Smaller and more superficial EGC lesions are more susceptible to misdiagnosis. The use of sedation and prolonged observation time during EGD could help reduce the occurrence of MEGC.
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Metadata
Title
Risk factors of missed early gastric cancer in endoscopic resected population: a retrospective, case–control study
Authors
Zhenyu Zhang
Ningjing Gao
Kun Liu
Muhan Ni
Xiang Zhang
Peng Yan
Min Chen
Xiaotan Dou
Huimin Guo
Tian Yang
Xiwei Ding
Guifang Xu
Dehua Tang
Lei Wang
Xiaoping Zou
Publication date
17-06-2024
Publisher
Springer US
Published in
Surgical Endoscopy
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-024-10970-0
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