| Background and Aims: Gastric cancer is the fourth most common cancer and the second leading cause of cancer death worldwide.In some Asian countries,screening esophagogastroduodenoscopy(EGD)has greatly improved the survival rate of gastric cancer.However,patients’ discomfort and the need for sedation may limit adherence to screening programs.Prior studies have shown good tolerance and good agreement of magnetically controlled capsule gastroscopy(MCCG)with EGD.This study was designed to assess the application of MCCG in ulcer,polyp,SMT,gastric cancer detection in an asymptomatic population and compared the differences of the disease in terms of gender,age,geographical area and so on.Methods:Through rigorous uniform criteria,we performed a multicenter study to evaluate the detection of ulcer,polyp,SMT,GC by MCCG and 3182 asymptomatic individuals in 99 participating medical examination centers from April to December 2016 were enrolled.Detection rate of gastric cancer and focal lesions were used to explore the application of MCCG in asymptomatic individuals.For patients with suspected gastric cancer and ulcers,by EGD and pathological biopsy to further confirm the diagnosis.Result:1.A total of 3182 asymptomatic individuals were enrolled in the 99 participating medical examination centers from April to December 2016.Of these medical examination attendees,1971(61.9%)were male and 1211(38.1%)were female;and the mean age was 44.8 years(range,18-94y),with the proportion of the 41-45 years age group accounting for the largest portion(11 patients were excluded from the age analysis due to the missing information).All patients completed MCCG examination.2.Gastric cancer screening result by MCCG:In the analysis for gastric cancer screening among these enrolled patients,seven patients(0.22%)were diagnosed with advanced cancer with two having multiple cancerous lesions.Among them,four were male and three were female.All of these patients were aged over 50 years and the detection rate of gastric cancer was 0.74% in individuals over 50.For per-lesion location analysis,prevalence in the gastric body was the highest(n=3,with lesions also identified in esophagus(n=1),cardia(n=2),fundus(n=1),angulus(n=1),and antrum(n=2),and all were through EGD and pathological biopsy confirmed as adenocarcinoma pathologically.3.Prevalence of other focal lesions:Typical asymptomatic lesions(including ulcers,polyp,SMT(including stomach and duodenum)were found in asymptomatic individuals were 609.Among them,49 cases having multiple lesions(≥2 lesion types).Among them,331(10.4%)patients had polyps,ulcer 156(4.9%),SMT 115(3.6%),and polyp,ulcer and SMT accounted for 58.4%,27.5% and 20.3% of the positive outcome.4.Prevalence of other focal lesions among different age groups and gender:There was an increasing prevalence of focal lesions with age(P<0.05)(one patient with polyps was excluded due to insufficient information).Prevalence of focal lesions were significantly higher in patients aged over 50 years.There was a higher prevalence of ulcers and a lower prevalence of polyps in males(both P<0.001),with no sex difference in the prevalence of SMTs.5.Safety evaluation:All patients swallowed capsules smoothly and MCCG examination was successfully performed in all the 3182 patients.The MCCG gastric examination time lasted from 1 to 142 min,with a mean time of 21(IQR 27)min.Of them,13 cases were less than 10 min,representing a complete rate of MCCG examination as 99.6%.In two-week follow up,capsule retention occurred in 27 cases(0.8%).However,all patients excreted the capsule spontaneously in the following 3-4 weeks after swallowing the capsule,without specific intervention or therapy aiding for the passage.Conclusion: As a new way,MCCG has a high detection rate for the screening of gastric diseases and can be found in cancer patients without clinical symptoms,which provides a comfortable,accurate and highly compliant way in screening for gastric cancer.Therefore,Studies of its role in a screening program should be considered. |
PDF Full Text Request