All the patients underwent routine preparation before the procedure. The detected lesions in high definition endoscopy were observed with optic enhancement mode. The endoscopist was required to give the real-time descriptions of surface pit patterns of the lesions, based on surface pattern classification. After that, biopsy specimens will be obtained respectively by forceps from each detected lesion recorded for histologic diagnosis.

Yanqing Li, PhD. MD.

The aim of the study is to evaluate the diagnostic value of high definition endoscopy and optic enhancement in gastric neoplasia.

High Definition Endoscopy and Optic Enhancement Endoscopy in Gastric Neoplasia: A Prospective Study

Shandong University

Vice president of Qilu Hospital

Gastric ablation is performed using the HALO Ablation System (BÂRRX Medical Inc., Sunnyvale, CA, USA). A HALO90 ablation catheter, which is mounted on the tip of an endoscope, is used. Radiofrequency energy is delivered at 40 W/cm2 and 15 J/cm2 via a 13 x 20 mm electrode. All patients will have two RFA sessions 8 weeks apart with the same area being ablated in consecutive endoscopies. The precise area to ablated in the second RFA session is determined by referring to careful measurements that utilized gastric landmarks (a typical notation may specify that the lesion extends from 2 to 5 cm proximal of the pylorus in the 5 o'clock position and is 4 cm wide) as well as to digital image recordings that are taken during the first RFA.

Radiofrequency ablation of dysplastic mucosa (HALO)

Francisco Baldaque-Silva, MD

The finding of gastric dysplasia not associated with macroscopic lesions (DNAML) or the follow-up of dysplasia after endoscopic resection (DAER) is a challenging dilemma. In the last few years, radiofrequency ablation (RFA) has become a recognized tool in the treatment of dysplastic Barrett's esophagus, but its use in gastric dysplasia has not yet been studied. The investigators aim to study the efficacy, safety and tolerability of RFA in the treatment of dysplastic gastric mucosa.

Gastric cancer is the fourth most common cancer and the second leading cause of cancer related death worldwide. The 10-year survival of patients with this malignancy is 20% due to advanced disease at the time of diagnosis. Screening programs in countries with a high incidence of gastric neoplasia aim to detect early stage cancer, suitable for curative treatment. Well-differentiated dysplastic gastric lesions limited to the mucosa (when non-ulcerated or ulcerated and less than 3 cm) or limited to the superficial submucosa (when less than 3 cm and with no lymphatic or vascular invasion) have a negligible risk of lymph node metastasis and are suitable for endoscopic curative treatment.

Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have been increasingly used in this setting with promising results. However, even with these advanced techniques, en bloc and R0 resection is not possible in up to 13-15% and 16-26% of the cases, respectively. The presence of dysplasia after endoscopic resection (DAER) in the post-resection scar presents a challenging dilemma due to the technical difficulty, and associated complications, of performing subsequent EMR/ESD in fibrotic tissue. Another issue of concern is the presence of gastric dysplasia not associated with macroscopic lesions (DNAML). In such cases, a targeted endoscopic treatment is difficult and clinical management is not standardized.

Radiofrequency ablation (RFA) has been increasingly advocated for the treatment of dysplastic Barrett's esophagus (BE) and early esophageal squamous cell carcinoma (ESCC), but its use in gastric dysplasia has not yet been tested. The investigators aim to study the role of gastric RFA in the treatment of DNAML and DAER.

Radiofrequency Ablation for the Treatment of Gastric Dysplasia

Ablation of Gastric Dysplastic Mucosa by a Novel Endoscopic Radiofrequency Device.

Hospital Sao Joao

Principal Investigator

Neoplasms

Digestive System Diseases

All Conditions

Symptoms and General Pathology

Rare Diseases

Stomach Neoplasms

Metaplasia

Gastrointestinal Neoplasms

Digestive System Neoplasms

Gastrointestinal Diseases

Stomach Diseases

Stomach Cancer

Douglas Morgan, MD, MPH

Ricardo Dominguez, MD

Potential patients will be recruited at participating sites based on routine care with clinical indications for upper endoscopy. Following informed consent, patients will undergo their scheduled endoscopy with standard forceps biopsies along with the transepithelial brush samples. All samples, biopsy and brush samples, will be sent for pathology analysis, per standard clinical practice.

Potential patients will be recruited at participating sites based on routine care with clinical indications for upper endoscopy. Following informed consent, patients will undergo their scheduled endoscopy with standard forceps biopsies along with the transepithelial brush samples. All samples, biopsy and brush samples, will be sent for histologic analysis, with planned study of the diagnostic yields of each method.

Novel Screening Modality for Early Gastric Cancer

Initial Analysis of Wide-area Transepithelial Sampling for the Detection of Gastric Neoplasia

To compare the diagnostic yield of the WATS approach versus standard gastric biopsy mapping (per the updated Sydney system).

University of Alabama at Birmingham

Professor of Medicine, Director, Division of Gastroenterology/ Hepatology

endomicroscopy, targeted biopsy and 16s rRNA gene sequencing

Yanqing Li, MD. PhD.

Ming Li, MD

wei wei, MD

There might be a correlation between gastric mucosal microbiome and mucosal pattern visualized by confocal laser endomicroscope.

The gastric mucosal microbiome plays a pivotal role in a series of diseases, such as the H.pylori infection. We hypothesized that mucosal patterns, here visualized by confocal endomicroscopy, may constitute specific microbiome niches.

The metagenome was obtained from biopsy specimen.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
High Definition Endoscopy and Optic Enhancement Endoscopy in Gastric Neoplasia: A Prospective Study	NCT02863965	Gastric Neoplas...		18 Years - 80 Years	Shandong University
Radiofrequency Ablation for the Treatment of Gastric Dysplasia	NCT01523912	Gastric Dysplas... Neoplasia	Radiofrequency ...	18 Years -	Hospital Sao Joao
Novel Screening Modality for Early Gastric Cancer	NCT04114006	Gastric Cancer		18 Years -	University of Alabama at Birmingham
Association Between Confocal Laser Endomicroscopic (CLE) Features and Gastric Mucosal Microbiome	NCT02063932	Mucosal Microbi... H.Pylori Intestinal Meta... Gastric Neoplas...	endomicroscopy,...	18 Years - 80 Years	Shandong University
Novel Screening Modality for Early Gastric Cancer	NCT04114006	Gastric Cancer		18 Years -	University of Alabama at Birmingham

Spots Global Cancer Trial Database for gastric neoplasia