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Endosc Int Open 2016; 04(10): E1083-E1089
DOI: 10.1055/s-0042-115408
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Effectiveness of systematic alphanumeric coded endoscopy for diagnosis of gastric intraepithelial neoplasia in a low socioeconomic population

Nancy Roxana Machaca Quea
1   Department of Medicine, Hospital Regional de Huacho, Lima, Peru
,
Fabian Emura
2   Advanced Gastrointestinal Endoscopy, EmuraCenter LatinoAmerica, Bogotá, Colombia
3   Emura Foundation for the Promotion of Cancer Research, Bogotá, Colombia
4   Division of Gastroenterology, Universidad de La Sabana, Bogotá, Colombia
,
Fernando Barreda Bolaños
5   Service of Gastroenterology, Department of Medical Specialties, National Institute of Neoplastic Diseases, Lima, Peru
,
Yuliana Salvador Arias
1   Department of Medicine, Hospital Regional de Huacho, Lima, Peru
,
Fernando Antonio Arévalo Suárez
6   Department of Pathology, Hospital Nacional Daniel Alcides Carrión, Lima, Peru
7   Hospital Guillermo Kaelin de la Fuente, Essalud, Lima, Peru
,
Alejandro Piscoya Rivera
7   Hospital Guillermo Kaelin de la Fuente, Essalud, Lima, Peru
8   School of Medicine, Faculty of Health Sciences, Peruvian University of Applied Sciences, Lima, Peru
› Author Affiliations
Further Information

Publication History

submitted28 January 2016

accepted after revision29 July 2016

Publication Date:
13 October 2016 (online)

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Background and study aims: In the Western world, gastric cancer (GC) usually presents at an advanced stage, carrying a high mortality rate. Studies have reported that 14 % to 26 % of GCs are missed at endoscopy up to 3 years before diagnosis. Systematic Alphanumeric Coded Endoscopy (SACE) has been proposed to improve quality of esophagogastroduodenoscopy (EGD) by facilitating a complete examination of the upper gastrointestinal tract. This prospective cross-sectional study was designed to determine the frequency of gastric intraepithelial neoplasia (GIN) by using the SACE approach in cohort of patients from low socioeconomic level. It also used non-targeted biopsies to evaluate the frequency of premalignant conditions.

Patients and methods: A total of 601 consecutive asymptomatic or dyspeptic patients were enrolled between January 2013 and November 2014 at the Huacho regional hospital in Peru. The SACE method proposed by Emura et al, which divides the stomach into 5 regions and 21 areas, was routinely used for diagnosis. Biopsy samples were obtained from any endoscopically detected focal lesion. To evaluate gastric premalignant conditions, 4 non-targeted biopsies were taken.

Results: A total of 573 patients were analyzed. The mean age was 57 years, and the female:male ratio was 1.9 : 1. In all cases, complete photo-documentation of the 21 gastric areas was achieved. The overall rate of detection of GIN was 2.8 %. Low-grade displasia, high-grade dysplasia, and adenocarcinoma were found in 13 (2.3 %), 2 (0.3 %), and 1 (0.2 %) of the patients, respectively. The prevalence of at least 1 premalignant condition was 31 %, and helicobacter pylori infection was found in 57 % of patients.

Conclusions: Using the SACE approach and with proper training, we have reported herein a high frequency of GIN in patients from a low socioeconomic status. Gastric cancer detection can be improved in a Western endoscopy setting when SACE, as a screening method, is performed by a trained endoscopist.

 

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