Matsunaga, KazuhiroNakanishi, HiroyoshiMinato, HiroshiAkiyama, ShinichiroTsuji, KunihiroKito, YosukeMiyajima, SaoriTakemura, KenichiKatayanagi, KazuyoshiTsuji, ShigetsuguYoshida, NaohiroHirai, HirokazuDoyama, HisashiWakita, ShigenoriSugiyama, GenMasunaga, TeppeiBackground White globe appearance (WGA) is a small white lesion with a globular shape identified during magnifying endoscopy with narrow-band imaging. However, the association between WGA and synchronous multiple gastric cancer (SMGC) remains unclear. Methods Consecutive patients who underwent endoscopic submucosal dissection for gastric cancer (GC) between July 2013 and April 2015 at our institution were eligible for this study. We excluded patients with a history of gastric tumor or gastrectomy. Patients who had more than 2 GCs in their postoperative pathological evaluation were classified as SMGC-positive, and patients who had at least 1 WGA-positive GC were classified as WGA-positive patients. The primary outcome was a comparison of the prevalence of WGA in patients classified as SMGC positive and SMGC-negative. Univariate and multivariate analyses were performed using the following variables: WGA, age, sex, atrophy, and Helicobacter pylori (H. pylori) status. Results There were 26 and 181 patients classified as SMGC-positive and SMGC-negative, respectively. Univariate analysis revealed that WGA-positive classification (50% vs. 23%, P=0.008) and male sex (88% vs. 66%, P=0.02) were significant factors associated with SMGC classification, while age ≥65 years (81% vs. 81%, P>0.99), severe atrophy (46% vs. 46%, P>0.99), and H. pylori positivity (69% vs. 65%, P=0.8) were not. In the multivariate analysis, only WGA-positive classification (odds ratio 2.78, 95% confidence interval 1.16-6.67; P=0.02) was a significant independent risk factor for SMGC. Conclusions Our exploratory study showed the possibility of WGA as a predictive factor for SMGC. In cases of WGA-positive gastric cancer, careful examination might be needed to diagnose SMGC. Keywords White globe appearance, gastric cancer, endoscopic submucosal dissection, synchronous multiple gastric cancer Ann Gastroenterol 2021; 34 (2): 183-187text/htmlapplication/pdfhttp://www.annalsgastro.gr/index.php/annalsgastro/article/view/5545engHellenic Society of GastroenterologyCopyright (c) 2021 Annals of Gastroenterology1792-74631108-7471Annals of Gastroenterology; Volume 34, No 2 (2021); 183White globe appearance is an endoscopic predictive factor for synchronous multiple gastric cancerinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion2021-03-06Δημοσίευση σε περιοδικόPublication in journalΓαστροεντερολογίαGastroenterologyisi -Gastroenterology & Hepatology covers resources on the anatomy, physiology, biochemistry, and pathology of the digestive system. This category includes specific resources on the prognosis and treatment of digestive diseases; stomach ulcers; metabolic, genetic, infectious and chemically induced diseases of the liver; colitis; diseases of the pancreas and diseases of the rectum.Επιστημονικό άρθροScientific articleΕλληνική Γαστροεντερολογική ΕταιρίαGreek Aggregator OpenArchives.gr | National Documentation Centre (EKT)other