Endoscopic Surveillance of Patients With Hereditary Diffuse Gastric Cancer

• DOI: 10.1097/pas.0b013e31826ca204
• Publication Date: 2012-10-16T10:25:37Z
• Authors: Hiroshi Fujita; Jochen K.M. Lennerz; Daniel C. Chung; Devanshi Patel; Vikram Deshpande; Sam S. Yoon; Gregory Y. Lauwers
• Keywords: Fundus (uterus)

The management of hereditary diffuse-type gastric cancer revolves around surveillance biopsies and the timing prophylactic gastrectomy. In absence a validated biopsy protocol, we modeled bioptic diagnostic yield on basis topographic distribution foci in series 10 gastrectomies CDH1-mutation carriers. Complete histologic examination was performed all cases, 1817 slides were evaluated for presence situ, intramucosal, or submucosal carcinoma. Detailed maps determined density foci. On number sampled glands per routine preoperative endoscopy, estimated theoretical necessary 90% rate detection neoplastic foci, this number, taking into account regional these A total 96 m mucosa with ∼1,193,453 yielded 302 [in situ (n=89), intramucosal (n=209), (n=4)] spanning width 1820 (8 to 1205 case; average 182±115). stomach during (28.7±1.7; range, 0 79; n=112), capture at least 1 focus be 1768 (range, 50 5832) assure rate. Mapping showed highest anterior proximal fundus (37%) cardia/proximal (27%). Our results argue incorporation any although is likely remain extremely low, they call question validity endoscopic surveillance.