TATPIKA_XPONIKA Movos Tavog A, Teinos 5-6, Ech 273-279 euvies 2003 eipouprint Kawich, Opwiow Fevd Necorousio Ehsvoiva - ABva Npwipog yaotpixég KapKivos Zuyxpovn SiayvwotiKe| Kal BepaneutiKy Mposéyyion, TEP. N. AOYPIAAE, F. MANAIQANNOY, A. NINOE, XP. IOPAANOY, N. EETAKHE CO meng yaotoxss noprivos amore’ ungprm evra jie oreuyarohoyia podem xahoranyooro rato Both arp rower Ka rBuoqoe Ba Madre va cua TEONOMBOWY MpOG My woreLELHEN Tiayratme tne vooau oF npuxia odbc yeyorog nou Ga eEeepooN Spanatar Behiaon TR MadywUONE eS ooou avvolisd. eon me BaymscwnTe exlBeeg ta EvEOONSTuN, 7 EXTOBEUON TuY XE\pOUPYEY ‘ononaoa ty cvermanare ra efaroaneyuere hpaBeverou, 7 cumoerTanoian Tw naBO}oyoGrETCuuy Nor eohee n Bekah naneypapre Tov Rodis gal anoreAcoustuy (epsies) anoTehoUY eaNorwad rot Gsoo evayrtions rexou BpaxerpaBao}us ovOxouR aNoTeAo 9 ueekeht ru OUEMaTeS oTaLONOHNOTS ts wd00u (unpoorabronomen) war pai npoeyxeorna ye rv endo? sures evboarorae BOWOS “roune Bapov we xoparenernd npou sapxiou. apa 9 ebehieyeEoTovonAepadEVETO HN ‘omuped, 8a Scoow wenon ory Sabon leroUpyea vax Mo repiopeutvaY eneuBaew” ye ocPOOH OT) aarpucyevaokovla nar Retoupyla xwpk oyehoyae ouBo04S. 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Hrpeti aur anoveds! ro {puede napd8upo evrdmiong tng v60ou TporEiueveu va eEaepanote! q.om npsywuon rat faon TOES gopes". Kard TO ‘dora auro n vo00g e&eNverai and ro aouAEW* Harika Kaj EvToRIoo craBIo oro couayaT- 6 aL Evtoriowio Kar TéAoS oTO cupmTaLATING Kat Erroniowo™ Apxra 0 Rpauiog yaorpRsS KaPKIVOR free KaBauroR Sival aourrajaTNeG, UNEP Gu hia unoowada aodewov evaug onoiouG Yia Kaioo xqAovovrat un ei ouurMuera OW SEOUENa He Uunoxeiuem xakorian yaorpuc nadokoyia (BvererTa} ‘uvBp04m, avauie, Xpowa crpopH navyacToInG) Tou pmopel va cnavekgoe: ro undorouya avamtueng piuan popeay mms vooou. Ze AAAoue jn e1SiKd ‘ujmrijuara: uonenine auvBoours exBMAvovTaL Grav ejipavioéel pixpo-etéixuan 1 Bidowon eve TOU KapKiVRad PhewoyévoU TOU NowIHoU KaPKIV fuarog, Eivar auth oudBa aropuv, nniag 45-55 ray, auc ye naka yaorpoen madoroyla Ka An xi yoowa oourrauarodoyia Suoneyiag N omar ‘anpootkdpomns avauias, aous onoious mpénet ve Enievsputel n Boro) rarpo) Kowerra mpoKEysevou va avroniaes ie npuiuies uoppes rg veaoUt Ynokoyiteta 6x, nepinoy 90% rou AuriKob rare Buouod xanoia atin mE dung tow Ga euoavicet Sucnernd eveyntota. ropa nAikiag 45-58 ery be Suonerrix oUvBpOuH, éxoUv miBavernra 1:50 Ya Eyouv noibuo yarrpKs Kapive. Ta cuKvétepa ‘cuureupata nou Karaypagovrat oe aeipé aodevy empsivo yaorpao kaprivo eit eruyacrpakyi, ent ‘yaorpin Budpopie “AAyoR relvags ew aKOROUBOUY ‘avila, eueros xa ouxves epuy Me my KareNAnAN ‘EucioGnronaon Kat eumetpia iver Ewar6 To 25% ‘uv nepmrdgewy va apepow nodes ops Ka, +o 50% va svar unoyrr ya Suns BepanevTIKS yeioovpyiKs yewons iver onpovtnd oF gorrmrés oss tarps OVOAES ve BSdonoveaL Gn. 0 RpaIUOs YaETPKER KaDKIVOS var unapem ovronra, Suma Seoarevon He 1a Undpyovta yeca, nai de ounmepvauBiverar oT Biagopodiayvaem ves arena ue aonon yaoTEK roBonovia Tv onoia uefa Aveta n yvwotaKt Suxpagn om onjeiohoyia npoxupnHEven eraBiou TS voou (kaxekia, Reypadévac YOU Virchow, aowtme ‘Mreropeyanie) yaMov yapaxmpterar avowora une ‘To nplova mg SwvarsrTrag warping Bepanciag. Mo pada to Aims ovo Yyeiog Mpénes va Enava: ‘RoooBioptoei ra roApta Maparoums wéong MAnlag, ‘grou pe sBuonermf owSpOM yia evBooKoMKS ‘Seeyye, (open access endoscopy policies), edv Be BENET va orataAd TouG népoUG Tou-crn épeuva KaL ‘poor agdeviv in Bepanevrinod crasiou ‘Avoupiopra n oYNAA eniracn rg vOooU oT amavis £321 GujBGAe ery anoKION KEpadauGBou fumeipiog oti Texuues aneKowans npsipou YaoTpr OU wapxivou (artwooxcrnan reat yaorpoaxénnan), {|XAd KaL om nepLypaUR TaENoUNEN KaIKaITYOOAO. foinon tov axwonoyinay wat evBooKOrUKN CHOVEN. H Yagxpooxdnnon nara exw napetoxt cupavitet Opnrsrepn Sieywucraxn axpiesa, napeyes Ty BVO rommra Bloyuy Rat MentouEpoUs xaptoyPapnoNS ‘ng BRABng (Bean, ueyEBOs, uoHpORoYia, MieavES ‘byxpoves BAdBeq-renvecroxsrmra mg véoOU) Kal ‘oro pehtov mpafhenerai va avewaraaTock RNIpws ov arzwohayind EAsy(O.H RuicnoAnon Tne yaoTpO ‘oxémmone emmy AvaToNT epiAaiBAvel Tov ReNTOuEDA, Kat ouommparkd ie OUYKERpIL DeIpe EAE¥HO OAOU ‘ou oTousxou, je eupdanon Bkapopents odoOS ‘pa oF TperG eaaEIG (HEraPONN aG}OU Me xwoNS {Yeorpixad PARwayovou) Kav ohoehnpUvera! He ey Engheign tou BAsivoy6vou ne xoworh oucia (indigo tarmine spray). Hohn Badkxaota Brapxst epinou 20 ana avekapriug 8¢ eypnyérw guroypaxpZeral A Bivrecoxonstrat kal opycioberetan Ue oxoRO th ‘yanion ie ev@e¥GueNn sedRovTun eEEraN, H eruovh Nat euiovh oe ehdnote adAauoaeiG rou BheWoyOroU. (xu, medjwon, ver KAN) cmtorehel ro wei Ya ‘rv evrénion malou YaoTewoo KapKiVU. ‘0 Gurus evSoox6nax, opeiet va evaxo8nronomn- ei kat va stava-nuxoreuot tov rp6no exteleO7S ‘ng vaotpooxonmons exueraiAeusucvor tv tepdata ‘2voouipev0n euneiplag Tov owaBEhpu cf AVATON, Wat Bea0 ot wa abvreun erioxérmon Tou yagtpe ou BRewoy6vou Sipnziag 2-5 henry OWvOSCHO HEM fn jie haxowet éxBear 26 oUVBUAOH Le aTOvOIA fomrucg eutesplag mg, WaXDoOROMUTC eUpawoTE RpGUDY YopRV Ing vEoOU HE LaBRATIR axptBEId OBnyE! ge Blaywaarin} aoroxia. dav Mee va Bex kavelg oro apuas ra” nati Yaorowy nari nov Sichabay eyrawone Byron svar ioepeeH05 Be fut6v nou Bieynsasneay ut =npoxepnevoc. 2r¥ yaio@nronoinan Ka enavernaiBevon Twy evb0oK6 rw omy evayvapon npdiou YaoTDNON KapKivoU, ‘pénet va npoote8e! Kat n xpfion xPwoTIY OUCIG (aye spray) nou anodederyueva augaver onuavend sng Seyvootraxpipera mg efzraong (PPV: postive predictive value ano 33% 0b 86%. poywworxoi napayovres, Sionoitan © mpi yaotpné napvos e€ optouod agops xaprivouta to onoie BmSoWv to Blewoyoro A Tov “noBasrveyovi saan aveEapmrngNevgasonac ouneroyg, Ta KoTaypagdpeva neooors hewpabe ‘oes cuuuevoyte om aphioypaRia nusaivovtat ar 2'tc 20%. heupebennh Sone owSvGCeT! He youmnsrepe nogoara smpiong, sore wat eige Batuvet cox oro npoyvaotno napdyovteg ‘swore bovore eupasonnry, Saonopag \ayvu0n, pixpo-oTa-reixos 56, Méios-loinos 2008 Téyos a anoreAodv ) 70 fsB0¢ Brno. ) YO uEye8OS ¥) 0 tarokayteés neg Kak 8) n HaxpeoxariKy exova™! ‘Ynepxe EexcBopn oxéam peraki Badous Be2nens nau mbavonros Asupasevatye Seiénone: ent ner ‘eu nov agopa Te PAswoyowo Tuva n MaVEMT, Ya Kavaypageral 2%, Tov UtOBADIVOYEMO 19.5%, TO [wiko 86.5% wan tov Uno-opoyaao 60%. AvTioTORN, Foxexwon nopampestat wat we TO weyEBOG THe BRA fing. Baafeg 20g 1.5 Ex. nopouetatouy ywxporepn ibavemnra uyKpTiNG is GUFEG 163.0 eK, 31-38 2. kak oon. Tehog avtiororn oxéon rapouRrGtet 1 warohaynds Tunos Kat N LERPOOKONIKT eiKGva! opriojara rai Btapopanoinan TeTou | xa a, {mponert way enieba> yUpig €AK05 FOUN) apo ‘otacouv jepdtepn maBavornta heygabenag Baro as, Hemimsam ing ABupadewerg CULUETONAG OE Eniong xaraypagel ovis avoxowsnéves éog area fripes" H erafinon oo8eviv ue xapatvouara TINO ai T2NO ayyouy ro 100% ce avzi8eon we AUT Tw TINT wat TANT MoU nyjaverar peTaEU 72 KaX 74%. Eniong oe nepiftuan Aeugatemnc Bijenons ent rapaeicnev TY (BAswyeveE-UTOBAzWOYOOR) OL Ieodpsparievor Asugadsteg apopody nara Kavova Tov omparo BartuNo» (laraym6 OoTHuA), ev OF Te (wkd) ovo 50% tay nepeTtuoeay To wesrepon™ Kava ouvensia elvat nah onjavnn® va: npocbiops. ‘row erimpéasera yapaxtnp\oTixd a oncia 8a 95, Sooouy an uversera va SaKePKOULE Ta TOMA apawaara wapiorne npdywwons Qwoig Asypabe ‘rt ouueroxt, eign 96%- 100%) an6 Ta -KaNE Inpéywaangs (ue Aew@adew CUMETOXt, emPiven bo%70%) 10 Kodoma nporeivetéva yersEedyiévo dora laxpo-avadionainang to orclo owbudte To Aabos Be Fanon he Tunoue staporagnsv nporGm Bxieneng ‘iaxpiee pia nperune BeBnon: eksqioro Phewoys- ‘to (SM small mucosa), erupaveiaxe erextewoyevo {Super M: supericia spreading) nai Scatepaivovta! * ‘Bnénnxe rou unoAevwoyewiou (Pen: penetating) To ‘ehavralo undiapetta: orev unorUnD Pen A (Ouaxe- Guevo avov unoBkewoysne, expanding) Kai Pen B {eaBeroulyoauuatg Brjenong erov unopewoysve). Kata to ouomjia Radoma 0, Tota. SM, Supor Ma Pen B rapousatouy xayn ri@avemra ayyeraKrg at Aeupeewns Barong Kal OuyxprKG ue Ta Pen B euigauZouv apiotn mpdywwon (90% enipiaxon ‘vara 65%). Tie nadohayoavarounés autés apa “mnpioeie erimpéobera ewoxoouy epeuves oxeTKG He ywsere pxp onjepa toredoynée AzrTonzoetec. H Jhon ebm BEITeV TOU NEUCYYEKOS evbO- Gmniow. (oodoplanin, prot, cesmopiakin, VEGFR 3, (2-40), ge oWvSvaHS UE avooOCTORTIMES Tex ég 9€ napaoxeuaguara Tapagims, TEBYBAOOUY sn ovyxpovn iorohoyer,exBOyt TOU heupayyetaKod Bucuoo™ Sayguva ye oUt, Aruoayyetaxa PROB ‘Tou Phewayawou Xtiva, CUYRAEKOUY RAL CUBAVZOUY hieyiom monvarra oro enneBo tou Bewayov0u ou yrara (Musou Mucosa), eve KawSev tou, (ov unoBhewoyouo, cuvevauvtar oxmarovTa Le Yakinepng Banerpou Asupayyeia. H avarowe aut TRoootyyion auwepunveus ne KAN Tapamproets 27s oer je 10 A805 xa ro MpsrUnO BuHOMONE Kat “ry nidavemnra Aeupadewntie Ouuetoxtc: ro erie Bo (pabog) ahha nal 0 xoporandg jxpo-6y%o5 (OE arog) Srjenens, unocmperar and tous (ious cpcumree on, oyenicera He ty mBavera NEHA Bevarig Staonopag. Enéxroon Tou rapRuasaroe cue xo enineBo MMISM, ue npotuno avantuéng Pen A (Bicxecueve - expanding), ouvsuaterar He GUE ieavémnra Aeupayyeiatic Bri@nenc Kev Biaoropas “me woo" To qvutepis Bteurpwitetar On xUOWY ea ‘a evepikod tUrou waprivauera Kat Oy yia ra ae yoru, yeyoves nou arasiSerat oF jloplakés GioTNrES, Tov TeAsUralaw (kopRVING KUTTOO. HEHOUNEVa Kat Oxt oF oydBea/Bragoperno BORUTTAPHO HOWEAD cm kOWwaviag-noNarhamayou) Kar ge eyyera aréheies, av upiarduevan yeobay (rTut evBoACOayYCIOR, evrsmtan HeOvAievay KODAK RUTTEDU) Exroe ano To Uye80s Ret To yOKPOOKOTIKG TOMO ‘kot a1 avuTépw MDoYWurKEL NapayOVTES ExT ‘rat ovohoviKs, H enoxpeayien me aywoaewe Kat 1 axaiprig craaionoinan, Kard AOvIKH axohousia, Neto powo nara yy raBokoyoavarojat e&fraoN ‘ng eaipefefoag prdpne, Kara cuvénea, now ond dtabrnote enepBana node, 1 Gkayrw2on Tou epiQioU Yaorpici xaprvauaros Mpénet va yapartpcerct be mer} (mBaveq Moaijos, YoorENKés, KaPKIVOR). ‘rohoUBue evorUmee To epueTAUA, NOVO OKOIBIC lunopel va etvaxn Bidywuon wat crabionoinen ony ‘uabrte enéupaom» wag BAdBng rou paxpooxorang Hnopel va avtioroxet of MpBUO yaoTPKS KapKivO hie ta unépyowra uéoa?. To epdtmua auro eva, aioiag oryaotas ue my ropaboxh ent © aobevnG ‘oviuetuniéera oe mepipaniou nou UnSpxe! oCoLa Bepanerixav enAOYOY avahaya pe TO eTEBIO THE vooou rou Kal we GUT ugar (0 eukodrroniamjevog, rat Eursieo¢ evbooKsnog ‘ret Buvnte BlEyORN TOU MpAMJOU YOoTPIKOL apmondavog, Repiypdget rh UaKpooROTN| exGva roo (rponertc, erimesy, edxaton), ty Beam TOU, “o_peyob0g Kar ridavoAayet To BaBds BeyeNoNG. H brdooKomnt unepmroypagia exe xanewarameet Ue ‘kon my npo-separctag eniepaivon me BusywwaNE (Gxriunem Baboug Senor) aka ax tng mBaveTag reupadewnrg cuuueroxte. H axpiBe ing y296Bou ‘avapopixd ye v0 860g Benen kupaivera. yeTaed 60-80%, evs OYeTIKG pe TH RewpaBevih OOMLETOXH iva, uddov anoyonteunue (PPV: 0-19%). Yuioees eganec (220 Megara) teheutoiag TexvOnoviag vB Fouseog 8a auejaouy m BrayrwoTIN aRpIBEI THE Hiebedou. 2a peioverthaTa THE WeBOBOU pO TO fRapdv nepihauBavoveat ry avdyen euane exraibeu Dong, n ueKpa ROLIUAN exUaBMONS (aBLwUsG Tepe (raruiv’),n unoxsijenxorTra vou cEetaot}, Kot Sreraan me Searwotng anaBerag TG Ent BAA hie Ekrog f OUNY Ka8UG Rat evroniocug cUTov oT tire-xapsiant poipa Tou erouexoU Kab RAL NBO A rapa ruAwpK® TEeek eves TeKAKES NOAUTONIKTC EdiKoEIBOUS ‘komt Touoypapias, uaymtig ToHOYPaGIas als at rojoypariag exc noCrpoview (PEM), Bev eu ‘gavouv aberpent SaywotHT OrPIPEa, anorehoy278 TPR xONKA e€etrmuéves kat aovupopss oucovoued emoyss Kat ‘ undpyoud epneipia cwpops odtydptGues avaxow 1g Ue HBS apLeAs nepwoTaTIKOy™”™ Ee avrisean ue 10ug Napardvw nepiopiopoug ai Ty jerpia veniBomn Tay MapARGM CUYAPOVI ‘anakomotwtlv eferéoeun, aBionadoeetn BraywoowK ‘axpixe xaraypdgeta: cm BBNoypagia and Kinwves uvabedpoue xeipoupyoug Kara ey BieyxeIpnTKA fxtiunon Tay BAaBav Tou Katé try evBooxénnan, you JoparmypoTE we «miBavé Now YaOTPIKG apxtvoparas" Eo, kava SGQKEIG Tg EMEBO tng, expat Rabo Bufnong AauBGvovTas UT iBavés wos weraBohés omy Uh KOLO xsd TOU Unepeiuevou opoyévou, ret onAagnmh exten, ne Bhan (up, axérna,jKpOOKOIK EAKS¥). 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H Burin mpi rowSTTS KON © rAr}Buouds Ba npéner va euaioBrronaMBowy poe ‘my xarevOuvon Biéywwone TE voooU oe Nowa ‘oraBia, 01 eundexojevec ewmornTes (yoorpevte- Bod6yo%. xe\poupyoL naBohoyoavaroyol) npéneL va ‘agojouscouv Try moAtmiun euneipia e& AvaroAGy ‘ofa malo peternaweUoewy eSiOU evBIApEPOVTO) eEelsevone H aun rou novoored nouto-Beéywwang yootpe ou wapxivou oT Aton oe “apxKE: OTB cMOTEAE| ‘ov axpoyanaio No Bedviwong ng npdywwang mE ‘dou, AKoROUBIG BedriWon Tg BayrUDTIC OX Bo1ag wv evBooxoray,n exnaiBeuon Tay yepeuByaN ‘3m ounoTéea me ouoMaTIxG AEUGABEVERTOUTS, n euaiodnronatin sav nadonoyoavet ohio Kal TEAOS 7 Bekriaon ravaypagrig Tuy Rodkeuy nat aTOTeAE: Cuca (registries) anorehowy peanioTnoUG wat deca vaynaioug ar6x0u, “Ta avojevouva try enduew Seria anoteNcouar, {and Youg npuronépoug om weds Kat avWErrIer ‘ou yaoTpHOU KapxIvoU, 790 OE epeUMNG Goo Ka te xhak® erinedo evecyousvog 6a Tporororhoow riko ro Biarvvotie wal Gepanevtixd GAYSDOKS ‘mg v6o0u, aKa xPONIK ABSTRACT Early gore cancer: Up ted slagnostic ana ‘therapeutic approach Early gat cancer, mimies common benign gastlc pathology and consiets a distinct clinica ent. Souls ‘Wester communities false the level of awareness regarding early diagnosis of gasiie cancer overall Sutval wl improve oramaticaly Improvement of endo Scopiss's agnostic accuracy, development of surgical experts in systomic and targeted Iymphadenectomy, Epotighting of eary lesione by pathologists and nally meticulous registering compsse all realise and Fecal pursuits. Short dated promotons consist of ‘Advancement of slaging systems, parboulary micro Staging, trough evaluton of endoscopic excision techniques ot minimal lesions compat wih say Cancer. In parallel, sentinel node navigation surgory vil Boost spread of minimal invasive toenniques and function preserving gastrectomigs without oncologic compromise Key words: early gastric cancer, endoscope ‘mucosal resection, personalized lymphadenectomy, Seminel nods BIBNOTPAGIA 2, Slat Good sna sts 0, Oconee ‘car humarenaen tw foe ot mass sven Sate ater Sos sareate| aa bg os sa ame wracoeae 1, Et uctun 7. apn Teh Ch, Low Co Manageme tape 2. Mou Ty orp oe nena an «Noe Aten rerio Le ae 8 9 Tranatde J Cres P Dagorts austen a pars sige c= ne a Peon Meas a ste yg mse etsy ae Nena of hp nose metres ao prognets n Secs ey eco ton an Sep ‘af rm Ta emit Shen evga par re a mts aa wh ‘a Ream Yah Son iiss Ovum. 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