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Analysis of endoscopic features for histologic discrepancies between biopsy and endoscopic submucosal dissection in gastric neoplasms: 10-year results
- Source :
- Digestive and Liver Disease. 51:79-85
- Publication Year :
- 2019
- Publisher :
- Elsevier BV, 2019.
-
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 Conclusions Careful endoscopic observation should consider size, ulceration, and depression to ensure accurate diagnosis when a gastric neoplasm is suspected.
- Subjects :
- Adenoma
Adult
Male
medicine.medical_specialty
Endoscopic Mucosal Resection
Endoscope
Biopsy
Adenocarcinoma
Young Adult
03 medical and health sciences
0302 clinical medicine
Stomach Neoplasms
medicine
Humans
Longitudinal Studies
Medical diagnosis
Aged
Aged, 80 and over
Hepatology
medicine.diagnostic_test
business.industry
Gastroenterology
Cancer
Middle Aged
medicine.disease
Dysplasia
030220 oncology & carcinogenesis
Disease Progression
Female
030211 gastroenterology & hepatology
Radiology
business
Gastric Neoplasm
Subjects
Details
- ISSN :
- 15908658
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Digestive and Liver Disease
- Accession number :
- edsair.doi.dedup.....5672a900ade96f4cc148c67ade3f35cd