ニシノ　タカヨシ   Nishino Takayoshi   西野　隆義    所属   医学部 医学科（附属八千代医療センター）    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Variation in the rate of detection of minute and small early gastric cancers at diagnostic endoscopy may reflect the performance of individual endoscopists.
掲載誌名	正式名：BMJ open gastroenterology 略　 称：BMJ Open Gastroenterol ISSNコード：20544774/20544774
掲載区分	国外
巻・号・頁	10(1),pp.e001143
総ページ数	9
著者・共著者	MURAKAMI Daisuke†*, YAMATO Masayuki, AMANO Yuji, NISHINO Takayoshi, ARAI Makoto
発行年月	2023/07
概要	OBJECTIVE:The documented variation in gastric cancer (GC) detection among endoscopists has often been dismissed as a coincidental artefact of the low incidence of gastric neoplasms; it is not considered associated with differences in physicians' performance of the esophagogastroduodenoscopy procedure. This study is to confirm whether significant variations among endoscopists in early GC detection suggest the individual performance of the upper endoscopy.DESIGN:A retrospective observational study at a single centre in Japan assessed the results of 218 early GCs detected during 25 688 routine esophagogastroduodenoscopies by 12 endoscopists. The main outcome was the rate of early GC detection for each endoscopist under the same circumstances. Other measures included the major diameters and locations of the lesions, Helicobacter pylori infection status, and baseline patient characteristics that could affect the prevalence of GC.RESULTS:The early GC detection rates exhibited wide variation among endoscopists (0.09%-2.87%) despite performing routine esophagogastroduodenoscopies in a population with a similar background. Endoscopists were assigned to a low-detection group (n=6; detection rate: 0.47% (range: 0.09%-0.55%)) and a high-detection group (n=5; detection rate: 0.83% (range: 0.63%-1.12%)), with the single highest detector analysed separately due to his distinct detection rate (2.87%). Endoscopists in the high-detection group had better detection rates for minute (major diameter ≤5 mm) and small (major diameter 6-10 mm) GCs than the low-detection group (0.19%/0.23% vs 0.085%/0.098%). These differences were significant (p<0.01), although there were no significant differences in detection of larger tumours (major diameter ≥11 mm; 0.40% vs 0.28%; p=0.13). The tumour location and H. pylori status were similar in the low-detection group, high-detection group and for the highest detector.
DOI	10.1136/bmjgast-2023-001143
PMID	37407230