			Home About us Contact

Endoscopic Screening (endoscopic + screening)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Lung cancer with metastases to the stomach and duodenum. report of three cases

DIGESTIVE ENDOSCOPY, Issue 3 2003
Hiroshi Nakamura
Over a period of about 1.5 years between September 1999 and April 2000, three cases of lung cancer that metastasized to the stomach and duodenum were encountered. Case 1 was a 74-year-old man with lung cancer at stage IV. During chemotherapy, he passed tarry feces, which led to an endoscopic examination. Subsequently, submucosal tumorous nodules were recognized in the stomach and descending portion of the duodenum, which were diagnosed as metastases. Case 2, a 59-year-old man, underwent radiotherapy for treatment of lung cancer at stage IV. He developed obstructive jaundice 15 months later and, following percutaneous drainage to correct the icteric condition, endoscopic examination was conducted. A 5-cm submucosal tumor was found at the descending portion of the duodenum and a diagnosis of obstructive jaundice caused by a duodenal metastasis was given. Case 3, an 81-year-old male with stage IIIb lung cancer had been receiving oral Tegafur uracil. Because of hypochondriac pain that had lasted for 2 weeks, an endoscopic examination was conducted. A tumorous lesion was discovered in the horizontal part of the duodenum, which proved to be a metastasis. Metastasis of a lung cancer to the digestive system is rare: gastric metastasis is only 4.5% and metastasis to the small intestine, 5.8%. However, our experience suggests that metastases to the digestive system occur more frequently than reports would indicate. Endoscopic screening should be aggressively used, not only for those cases that develop subjective symptoms, but also for the asymptomatic cases to assess accuracy in staging, which may contribute to choosing the most appropriate therapeutic plan. [source]

Endoscopic screening for esophageal varices in cirrhotic patients

HEPATOLOGY, Issue 2 2002
Oliviero Riggio M.D.
No abstract is available for this article. [source]

Familial trends of inheritance in gastro esophageal reflux disease, Barrett's esophagus and Barrett's adenocarcinoma: 20 families

DISEASES OF THE ESOPHAGUS, Issue 1 2007
R. S. Sappati Biyyani
SUMMARY., We reported four families with familial Barrett's esophagus (FBE) in 1993. This follow-up study includes an additional 16 families with FBE, gastroesophageal reflux disease (GERD) and BE-related adenocarcinoma (BEAC) highlighting the familial trends of inheritance. A retrospective survey of endoscopic and histopathological reports on 95 confirmed cases of BE from 1975 to 2005 was performed and a detailed family history was obtained. Five representative pedigrees from a total of 20 are discussed here. These 20 families represent one of the largest cohorts studied over three decades from a single institution. Familial BE is more common than previously thought and the prevalence of GERD, BE and BEAC in these families is distinctly higher than with sporadic cases. The conditions appear to be inherited in an autosomal dominant fashion with incomplete penetrance. Hence diligence in taking family history with BE patients is critical since the endoscopic screening of relatives is warranted in FBE. Earlier diagnosis and surveillance of FBE should hopefully improve outcomes. [source]

Prospective validation of P2/MS noninvasive index using complete blood counts for detecting oesophageal varices in B-viral cirrhosis

LIVER INTERNATIONAL, Issue 6 2010
Beom Kyung Kim
Abstract Backgrounds: Periodic endoscopic screening for oesophageal varices (OVs) and prophylactic treatment for high-risk OVs (HOVs; medium/large OVs or small OVs plus red sign/decompensation) are currently recommended for all cirrhotic patients. However, if a simple, noninvasive test is available, many low-risk patients may reliably avoid endoscopy. Aims: We conducted a large-scale validation study of a simple, noninvasive test called P2/MS based on complete blood counts, (platelet count)2/[monocyte fraction (%) × segmented neutrophil fraction (%)], and compared it with other predictive tests for HOVs in B-viral cirrhotic patients. Methods: From 2008 to 2009, we prospectively enrolled 318 consecutive B-viral cirrhotic patients. All underwent endoscopy and laboratory evaluation. Results: An area under the receiver operating characteristic curve of P2/MS was 0.941 for HOVs, comparable with those of the age,spleen platelet ratio index (0.922, P=0.317) and spleen,platelet ratio index (0.922, P=0.324), and better than those of age,platelet index (0.653, P<0.001), aspartate aminotransferase (AST),platelet ratio index (0.871, P<0.006) and AST-alanine aminotransferase ratio (0.644, P<0.001). P2/MS<11 reliably identified 83 patients as having HOVs (94.0% positive predictive value), while at a cutoff of 25 and 179 as not having HOVs (94.4% negative predictive value). Overall, P2/MS reliably determined the likelihood of HOVs in 262 patients (82.4%). These cutoffs were validated internally using bootstrap resampling methods, which showed good agreement. Conclusions: P2/MS is a simple, accurate and economical method, reducing the need for endoscopy in B-viral cirrhosis. Patients with P2/MS<11 should be considered for appropriate prophylactic treatments, while those with P2/MS>25 may avoid endoscopy reliably. [source]

Non-invasive diagnosis of large oesophageal varices with FibroTest in patients with cirrhosis: a preliminary retrospective study

LIVER INTERNATIONAL, Issue 3 2006
Dominique Thabut
Abstract: Background and aims: Primary prevention of variceal bleeding with ,-blockers improves survival in patients with large oesophageal varices (LOV). Therefore, cirrhotic patients frequently undergo screening endoscopy. As portal hypertension is related to liver fibrosis, this study aimed to assess the predictive value of FibroTest, a non-invasive marker of liver fibrosis, for the diagnosis of LOV in cirrhotic patients. Methods: Ninety-nine cirrhotic patients had clinical examination, blood sample (liver function tests, platelet count, FibroTest) and upper endoscopy. Measurements of endoscopic and biochemical parameters were made blindly. Sensitivity, specificity, predictive values and area under the receiver operating characteristic curves were assessed for FibroTest, platelet count and Child,Pugh score. The main endpoint was the presence of LOV. Results: Platelet count, prothrombin time, ascites, FibroTest and Child,Pugh class were significantly different among patients with or without LOV. FibroTest had the highest discriminative power with an area under receiver operating characteristics curves of 0.77 (SE=0.06), compared with 0.64 (0.08) and 0.68 (0.08) for platelet count and Child,Pugh score, respectively (P=0.08). A cut-off at 0.80 had a 86% negative predictive value for the diagnosis of LOV (Se=92%, Sp=21%). Conclusion: FibroTest could aid in the diagnosis of LOV and may therefore reduce the indication of endoscopic screening in cirrhotic patients. [source]

Chemoprevention of colorectal cancer

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 1 2004
E. D. J. Courtney
Summary Colorectal cancer is a disease with a high mortality at present, due to the late stage at which many cases present. Attention is therefore focusing on preventative strategies for colorectal cancer given that polyps appear to be identifiable and treatable precursor lesions of this disease. Endoscopic polypectomy has been shown to reduce the incidence of colorectal cancer and there is a good case for endoscopic screening of the general population. However, this will require a large amount of manpower and resources and its success will also depend on the overall compliance of the population. Epidemiological studies have shown that individuals reporting a regular intake of aspirin and other non-steroidal anti-inflammatory drugs have a reduced risk of developing colorectal polyps and cancer. Similarly, a number of natural substances, such as calcium and folate, when supplemented regularly in the diet, have also been linked to a possible decreased incidence of colorectal cancer. This has led to the concept of using such agents to reduce the number of cases of colorectal cancer. In this article, we review the current evidence for the use of these and other agents for the chemoprevention of colorectal cancer, together with theories as to their possible mechanisms of action. [source]

Association of prediagnosis endoscopy with stage and survival in adenocarcinoma of the esophagus and gastric cardia,

CANCER, Issue 1 2002
Gregory S. Cooper M.D.
Abstract BACKGROUND Barrett esophagus, a consequence of chronic gastroesophageal reflux disease, is a premalignant condition for adenocarcinoma of the esophagus and, possibly, the gastric cardia. However, the actual use and clinical impact of upper gastrointestinal endoscopy in screening and surveillance for Barrett esophagus are unknown. METHODS A cohort included 1633 patients with adenocarcinoma (777 esophagus, 856 cardia) who were 70 years or older. They were diagnosed between 1993 and 1996 and were identified from the Surveillance, Epidemiology and End Results program registry. All claims for upper endoscopy and a diagnosis of Barrett esophagus from 1991 through 1 year before diagnosis were identified from linked Medicare files. RESULTS One or more upper endoscopies before diagnosis were performed in 9.7% of patients (13.0% esophagus, 6.8% cardia) and a diagnosis of Barrett esophagus was present in only 3.7% of patients. A shift toward earlier stage at diagnosis was observed in patients with previous endoscopy or Barrett diagnosis. For example, 62% of patients with esophageal and 49% of patients with cardia tumors who underwent previous endoscopy presented with in situ or local stage carcinoma, compared with 35% and 27% of other patients, respectively. Receipt of endoscopy was also associated with a reduced risk of death for esophageal adenocarcinoma (relative hazard 0.73, 95% confidence interval 0.57,0.93; P = 0.01), but not for adenocarcinoma of the cardia. CONCLUSIONS Receipt of upper endoscopy at least 1 year before diagnosis of adenocarcinoma, which may reflect prediagnosis screening, was associated with an earlier tumor stage and improved survival. These data support the role of endoscopic screening and surveillance for Barrett esophagus and highlight the underdiagnosis of populations at risk. Cancer 2002;95:32,8. © 2002 American Cancer Society. DOI 10.1002/cncr.10646 [source]