Early Gastric Cancer Clinical Trial
Official title:
The Feasible Research of Infrared Endoscope to Diagnose Early Gastric Cancer and Evaluate the Invasive Depth of Tumors
The gastric cancer is the second most frequently diagnosed cancer and the third leading
cause of cancer death in China.80%-90% patients were detected at middle and later stage.The
five-year survival rate for advanced gastric cancer patients is less than 10% due to the
shortage of effective treatment method.The five-year survival rate for early gastric cancer
patients is beyond 90%.The reason for poor diagnosis and treatment is that current methods
do not achieve the diagnosis of early gastric cancer.Endoscopy with biopsy is still the main
method for confirming gastric cancer.But it is limited to identify early gastric cancer and
it leads to the low diagnostic rate of early gastric cancer.
Infrared endoscopic imaging is a new great potential method of diagnosis of early gastric
cancer, since the first report in the 1990s, people have been exploring in this field.
Through intravenous injection of exogenous contrast medium, such as the indocyanine green,
it makes mucosal lesions highlight,and avoids the interference of background light.If
specific target molecular is linked to the contrast medium,the specific imaging of the
lesion can be presented. What is more,due to the strong penetration power of infrared
light,its imaging depth also increases significantly.Indocyanine green had also been
demonstrated safe in clinical studies and widely used. On this basis,we apply for the
research about near-infrared endoscopy to diagnose early gastric cancer,and discuss its
feasibility of the infrared endoscopy to diagnose early gastric cancer and clinical value.
The gastric cancer is the second most frequently diagnosed cancer and the third leading
cause of cancer death in China.80%-90% patients were detected at middle and later stage.The
five-year survival rate for advanced gastric cancer patients is less than 10% due to the
shortage of effective treatment method.The five-year survival rate for early gastric cancer
patients is beyond 90%.The reason for poor diagnosis and treatment is that current methods
do not achieve the diagnosis of early gastric cancer.Endoscopy with biopsy is still the main
method for confirming gastric cancer.But it is limited to identify early gastric cancer and
it leads to the low diagnostic rate of early gastric cancer.
Accurate diagnosis for early gastric cancer and the pretherapeutic estimation of the
invasion depth is desired to determine suitable treatment.Presently,endoscopic submucosal
dissection is the new effective minimally invasive treatment for early gastric cancer,which
preserve the entire stomach and improve the patient's postoperative quality of life.But the
estimation of invasion depth of gastric cancers should be confirmed before operation.
Recently,some research suggest that narrow banding imaging and endoscopy ultrasonography are
considered established means of diagnosis for early gastric cancer and depth.No formal
quantitative review of the available evidence has been published that narrow banding imaging
or endoscopy ultrasonography could accurately diagnose early gastric cancer and evaluate the
invasive depth.This means still has great limitations.The sensitivity of narrow banding
imaging diagnosis is only 60% which its high false positive rate,shorter wavelength and
lighter penetration,and the result is influenced by histologic variety of early gastric
cancer and inflammatory changes in the background mucosa;Although endoscopy ultrasonography
achieves a diagnostic accuracy of over 80%,and its tomographic views facilitate objective
assessments,it is occasionally difficult to obtain images with adequate quality, and its
evaluation is highly dependent on operators' proficiency levels.
Infrared endoscopic imaging is a new great potential method of diagnosis of early gastric
cancer, since the first report in the 1990 s, people have been exploring in this field.
Through intravenous injection of exogenous contrast medium, such as the indocyanine green,
it makes mucosal lesions highlight,and avoids the interference of background light.If
specific target molecular is linked to the contrast medium,the specific imaging of the
lesion can be presented. What is more,due to the strong penetration power of infrared
light,its imaging depth also increases significantly.Indocyanine green had also been
demonstrated safe in clinical studies and widely used, such assessment of liver function
tests.
At present,the research in this aspect is very few, a few clinical research results show
that infrared endoscopic imaging has a larger value for differentiating between early
gastric cancer and gastric adenoma, and the difference between early gastric cancer and
gastric lesions is significantly correlated with the depth of cancer invasion.
However, there is not a system research about the infrared imaging characteristics of
gastric cancer and different precancerous status,and there is no infrared endoscopic imaging
assessment criteria for diagnosis of gastric cancer.
Recently, we have completed the experiments on animals about infrared imaging, the results
prove that it has good specificity to identify tumor lesion. On this basis,we apply for the
research about near-infrared endoscopy to diagnose early gastric cancer,and discuss its
feasibility of the infrared endoscopy to diagnose early gastric cancer and clinical value.
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Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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