ArticleJournal of gastroenterology2021
Enhanced endoscopic detection of occult gastric cancer in carriers of pathogenic CDH1 variants.
Article in Journal of gastroenterology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 33 citations in OpenAlex.
- Endoscopic detection of signet ring cell carcinoma in CDH1 carriers: a 15-year single-centre experience.Familial cancer · 2026Article
- The Changing Landscape of Hereditary Diffuse Gastric Cancer.Journal of gastric cancer · 2026Review
- Spatial Analysis of Hereditary Diffuse Gastric Cancer Reveals Indolent Phenotype of Signet Ring Cell Precursors.Molecular cancer research : MCR · 2025Article
- Review
- Adolescents and young adults with germline CDH1 variants and the risk of overtreatment.Journal of the National Cancer Institute · 2025Article
- Disappearing Signet Ring Cell Adenocarcinoma in Gastric Cancer Patients.Annals of surgical oncology · 2024Article
- Endoscopic screening for identification of signet ring cell gastric cancer foci in carriers of germline pathogenic variants in CDH1.Familial cancer · 2024Article
- Diffuse Gastric Cancer: A Comprehensive Review of Molecular Features and Emerging Therapeutics.Targeted oncology · 2024Review
- Current advances and challenges in Managing Hereditary Diffuse Gastric Cancer (HDGC): a narrative review.Hereditary cancer in clinical practice · 2024Review
- Factors associated with detection of hereditary diffuse gastric cancer on endoscopy in individuals with germline CDH1 mutations.Gastrointestinal endoscopy · 2023Article
- Non-targeted biopsies in hereditary diffuse gastric cancer: Necessary, but not enough.Translational cancer research · 2023Article
- Chromoendoscopy in Combination with Random Biopsies for Patients with Pathogenic CDH1 Mutations Undergoing Endoscopic Surveillance.Journal of gastrointestinal cancer · 2023Article
- Review
- Cancer surveillance as an alternative to prophylactic total gastrectomy in hereditary diffuse gastric cancer: a prospective cohort study.The Lancet. Oncology · 2023Article
- Decision-making and regret in patients with germlineJournal of medical genetics · 2023Article
- Hereditary Diffuse Gastric Cancer-Update Based on the Current Consort Recommendations.Current oncology (Toronto, Ont.) · 2022Article
- Characterization of E-cadherin expression in normal mucosa, dysplasia and adenocarcinoma of gastric cardia and its influence on prognosis.World journal of gastrointestinal oncology · 2022Article
- Endoscopic Surveillance in Patients with the Highest Risk of Gastric Cancer: Challenges and Solutions.Cancer management and research · 2022Review
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
backgroundGermline inactivating variants in the CDH1 tumor suppressor gene impart an elevated lifetime risk of diffuse gastric cancer. The current endoscopic surveillance method depends upon random gastric biopsies for early cancer detection.
methodsAsymptomatic adults with pathogenic or likely pathogenic CDH1 variants referred for endoscopic gastric cancer surveillance were included in this retrospective cohort. Upper gastrointestinal endoscopy was performed according to the consensus Cambridge method, in the early period, or a systematic (Bethesda) protocol as part of an ongoing natural history study. The primary outcome measure was cancer detection.
resultsCollectively, 135 endoscopic surveillance procedures were performed in 120 patients. Twenty-six (19%, 26/135) procedures were performed using Cambridge method and 109 (81%) using the Bethesda protocol. Gastric signet ring cell carcinomas were detected in 15% (4/26) using the Cambridge method and 36% (40/109) using the Bethesda protocol (p < 0.05). Almost half (44.2%, 53/120) of patients later elected for prophylactic total gastrectomy, of whom 51 (96%, 51/53) had a signet ring cell carcinoma (T1a) discovered by histopathology. On a per endoscopy basis, the false-negative rates of detection using Cambridge method and Bethesda protocol were 80% (12/15) and 37.7% (17/45), respectively (p < 0.01).
conclusionsGastric cancer detection was more frequent with implementation of a systematic surveillance protocol in CDH1 variant carriers. Given the decision for prophylactic surgery is often made by patients in the context of family history and pathologic result of surveillance biopsies, we propose the Bethesda protocol offers patients an opportunity to make more informed decisions.
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