Published online Aug 15, 2024. doi: 10.4251/wjgo.v16.i8.3529
Revised: May 26, 2024
Accepted: June 18, 2024
Published online: August 15, 2024
Processing time: 104 Days and 11.9 Hours
Minute gastric cancers (MGCs) have a favorable prognosis, but they are too small to be detected by endoscopy, with a maximum diameter ≤ 5 mm.
To explore endoscopic detection and diagnostic strategies for MGCs.
This was a real-world observational study. The endoscopic and clinicopathological parameters of 191 MGCs between January 2015 and December 2022 were retrospectively analyzed. Endoscopic discoverable opportunity and typical neoplastic features were emphatically reviewed.
All MGCs in our study were of a single pathological type, 97.38% (186/191) of which were differentiated-type tumors. White light endoscopy (WLE) detected 84.29% (161/191) of MGCs, and the most common morphology of MGCs found by WLE was protruding. Narrow-band imaging (NBI) secondary observation detected 14.14% (27/191) of MGCs, and the most common morphology of MGCs found by NBI was flat. Another three MGCs were detected by indigo carmine third observation. If a well-demarcated border lesion exhibited a typical neo
WLE combined with NBI and indigo carmine are helpful for detection of MGCs. A clear demarcation line combined with a typical neoplastic color using nonmagnifying observation is sufficient for diagnosis of MGCs. ME-NBI improves the endoscopic diagnostic confidence of MGCs.
Core Tip: Minute gastric cancers (MGCs) represent the incipient stage of GC; therefore, they may be missed during endoscopy because the maximum diameter is ≤ 5 mm. Narrow-band imaging secondary observation combined with indigo carmine third observation could detect MGCs missed by white light endoscopy. A lesion with a clear demarcation line and a typical neoplastic color using nonmagnifying observation can be diagnosed as MGCs.