Early Gastric Cancer: Diagnosis and Management

EGC is defined as carcinoma confined to the mucosa or submucosa, irrespective of lymph node status. Helicobacter pylori infection is the principal driver of gastric carcinogenesis, initiating the Correa cascade of gastritis, atrophy, intestinal metaplasia, dysplasia, and carcinoma. High-definition endoscopes and magnifying NBI enhance the ability to recognize subtle mucosal abnormalities. Key diagnostic indicators of EGC include focal color changes (reddish or whitish) and surface change on white light imaging, as well as the presence of a demarcation line with irregular microvascular and microsurface patterns within it on magnifying NBI (VS classification). The treatment strategy for EGC is determined by three main factors: depth of invasion, lateral extension, and tumor subtype. Successful endoscopic resection depends on multimodal evaluation and strict adherence to well-defined selection criteria.