Noh, Choong-Kyun; Jung, Min Wook; Shin, Sung Jae; Ahn, Ju Young; Cho, Hyo Jung; Yang, Min Jae; Kim, Soon Sun; Lim, Sun Gyo; Lee, Dakeun; Kim, Young Bae; Cheong, Jae Youn; Lee, Kee Myung; Yoo, Byung Moo; Lee, Kwang Jae
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
2018Sep ; 145 ( 17 ) :.
PMID : 30236767
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Noh, Choong-Kyun - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: cknoh23@gmail.com.
Jung, Min Wook - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Shin, Sung Jae - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea. Electronic address: shsj9128@ajou.ac.kr.
Ahn, Ju Young - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Cho, Hyo Jung - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Yang, Min Jae - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Kim, Soon Sun - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Lim, Sun Gyo - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Lee, Dakeun - Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea.
Kim, Young Bae - Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea.
Cheong, Jae Youn - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Lee, Kee Myung - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Yoo, Byung Moo - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
Lee, Kwang Jae - Department of Gastroenterology, Ajou University School of Medicine, Suwon, Republic of Korea.
ABSTRACT
BACKGROUND AND AIM: The histologic discrepancies between preoperative endoscopic forceps biopsy (EFB) and endoscopic submucosal dissection (ESD) specimens sometimes confuse the endoscope operator. This study aimed to analyze the limitation of the biopsy-based diagnosis before ESD and to evaluate which factors affect the discordant pathologic results between EFB and ESD.
METHODS: A total of 1427 patients, who were diagnosed with gastric adenoma by EFB, were enrolled. Cancer confirmed on EFB was excluded (n?=?513). We retrospectively reviewed cases and compared histologic diagnoses in the biopsy sample with the final diagnosis in the endoscopically resected specimen.
RESULTS: The diagnosis was upgraded (from low-grade dysplasia to high-grade dysplasia or adenocarcinoma, or from high-grade dysplasia to adenocarcinoma) in 328 cases (23.0%), concordant in 944 (66.1%), and downgraded (from high-grade dysplasia to low-grade dysplasia or non-neoplasia, or from low-grade dysplasia to non-neoplasia) in 155 (10.9%). Multivariate logistic regression analysis showed that surface ulceration and depressed lesions were associated with significant risk factors for upgrading. Age younger than 60 years and size <1?cm were associated with significant factors for downgrading.
CONCLUSIONS: Careful endoscopic observation should consider size, ulceration, and depression to ensure accurate diagnosis when a gastric neoplasm is suspected. CI - Copyright ??2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
keyword
Adenoma; Biopsy; Endoscopic submucosal dissection; Histology
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