Clinical Endoscopy

Recent advancement in endoscopic diagnosis for risk stratification of gastric cancer: Takuma Hiramatsu, Naomi Kakushima, Hikaru Kuribara, Ryohei Miyata, Hideki Nakagawa, Hiroyuki Hisada, Dai Kubota, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Chihiro Takeuchi, Seiichi Yakabi, Yosuke Tsuji, Nobutake Yamamichi, Mitsuhiro Fujishiro; Clin Endosc 2025;58(6):787-796. Published online July 10, 2025; DOI: https://doi.org/10.5946/ce.2024.355

Abstract PDF PubReader ePub: Approximately 90% of cases of gastric cancer (GC) are caused by Helicobacter pylori infection, and screening esophagogastroduodenoscopy is effective for secondary prevention of GC. Endoscopic findings of the stomach due to H. pylori infection vary widely, and the risk of GC varies according to each finding. GC risk is evaluated by combining endoscopic and histopathological findings. In the operative link on gastritis assessment and operative link on gastric intestinal metaplasia assessment staging, GC risk is determined by histopathological evaluation. In the endoscopic grading of gastric intestinal metaplasia, Kyoto classification, and modified Kyoto classification, the risk is considered based on endoscopic findings. However, evaluating endoscopic findings is challenging because the evaluation varies depending on the skill of the endoscopist. Similarly, histopathological findings can be assessed differently by different pathologists. Histopathological evaluation by biopsy carries a risk of bleeding; thus, simpler and less-invasive risk stratification methods are desirable. Artificial intelligence for risk stratification, which has the potential for improved accuracy and consistency, has been developed for endoscopic and histopathological evaluations. Appropriate GC risk stratification would benefit the economy and patients, and further evaluation of surveillance intervals tailored to individual risks is warranted.

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Sarcopenia in the era of aging populations: its clinical implications for peptic ulcer bleeding: Hiroyuki Hisada, Yosuke Tsuji, Mitsuhiro Fujishiro; Clin Endosc 2025;58(3):401-403. Published online May 28, 2025; DOI: https://doi.org/10.5946/ce.2025.104

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Clinical meaning of sarcopenia in patients undergoing endoscopic treatment: Hiroyuki Hisada, Yosuke Tsuji, Hikaru Kuribara, Ryohei Miyata, Kaori Oshio, Satoru Mizutani, Hideki Nakagawa, Rina Cho, Nobuyuki Sakuma, Yuko Miura, Hiroya Mizutani, Daisuke Ohki, Seiichi Yakabi, Yu Takahashi, Yoshiki Sakaguchi, Naomi Kakushima, Nobutake Yamamichi, Mitsuhiro Fujishiro; Clin Endosc 2024;57(4):446-453. Published online March 22, 2024; DOI: https://doi.org/10.5946/ce.2023.193

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With increasing global life expectancy, the significance of geriatric assessment parameters has increased. Sarcopenia is a crucial assessment parameter and is defined as the age-related loss of muscle mass and strength. Sarcopenia is widely acknowledged as a risk factor for postoperative complications in diverse advanced malignancies and has a detrimental effect on the long-term prognosis. While most studies have primarily concentrated on the correlation between sarcopenia and advanced cancer, more recent investigations have focused on the relationship between sarcopenia and early-stage cancer. Endoscopic submucosal dissection (ESD), which is less invasive than surgical intervention, is extensively employed in the management of early-stage cancer, although it is associated with complications such as bleeding and perforation. In recent years, several reports have revealed the adverse consequences of sarcopenia in patients with early-stage cancer undergoing ESD. This literature review briefly summarizes the recent studies on the association between sarcopenia and ESD.

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Correlation between sarcopenia and esophageal stenosis following endoscopic submucosal dissection and construction of a postoperative stenosis risk model
Kai-Zhe Yang, Lu Chen, Li Xu, Bin-Xiang Xu, Ming-Yue Li, Zhi Wang, Qin Lu
World Journal of Gastroenterology.2026;[Epub] CrossRef
Sarcopenia in the era of aging populations: its clinical implications for peptic ulcer bleeding
Hiroyuki Hisada, Yosuke Tsuji, Mitsuhiro Fujishiro
Clinical Endoscopy.2025; 58(3): 401. CrossRef
Clinical Significance of Sarcopenia in Elderly Patients Undergoing Endoscopic Submucosal Dissection: A Systematic Review and Meta-analysis
Yuanhao Su, Yongke Wu, Cheng Li, Yiyuan Zhao, Yunhao Li, Xing Jin, Zhidong Wang
Digestive Diseases and Sciences.2024; 69(8): 2970. CrossRef

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