Abstract
The screening performance of transnasal and standard transoral esophagogastroduodenoscopies (EGDs) was compared by analyzing the detection rates of gastric mucosal neoplasias (adenoma and cancer) by each endoscopy based on the pathological conditions of the background gastric mucosa, especially according to the stages of the progression of H.pylori-related chronic gastritis. The transnasal EGD group included 1,280 subjects and the detection rate of gastric mucosal neoplasias was 1.64% (21/1,280), while the standard EGD group included 1,707 subjects and the detection rate of 1.87% (32/1,707), indicating no significant difference between the two groups. Likewise, the detection rate of the two endoscopies was in a comparable level regardless of H.pylori infection. However, the detection rate by standard EGD (0.79%) was significantly higher in the screening of a group of subjects without gastric atrophy than that by the transnasal EGD group (0.13%) (P<0.05). Especially, the standard EGD was significantly better in the detection of neoplasias in subjects with H.pylori-related non-atrophic gastritis; the detection rate in the standard EGD group (3.11%) was significantly higher than that in the transnasal EGD group (0.53%) (P<0.05). These results indicate that the diagnostic performance of a transnasal endoscope is suboptimal in the cancer screening, especially in a group of subjects with H.pylori-related non-atrophic gastritis.
