Diagnosis of Esophagogastric Tumors

Introduction This review focuses on the topic of neoplastic lesions that develop from the epithelium of the esophagogastric mucosa; other malignant lesions have been discussed in a previous review in Endoscopy [ 1 ]. Neoplastic lesions develop in the stratified squamous epithelium (esophagus) and in the columnar epithelium (Barrett9s esophagus and stomach). The standardized incidence of esophageal squamous-cell cancer has been relatively stable in recent times, in contrast to an increasing incidence of adenocarcinoma in the esophagus and a decreasing incidence of noncardia stomach cancer. The detection of esophagogastric tumors rarely occurs at the preclinical stage, and their prognosis is poor. Common sense suggests a need to increase the rate of early detection. This strategy raises some questions, however: is early diagnosis always beneficial for the patient? What technological facilities are needed in order to detect preclinical neoplastic flat lesions and stage them? Can molecular biology make a contribution? Which guidelines should be adopted for quality assurance in diagnostic endoscopy?