Authors: Hyun Lim HwoonYong Jung Young Soo Park Hee Kyong Na Ji Yong Ahn Ji Young Choi Jeong Hoon Lee MiYoung Kim KwiSook Choi Do Hoon Kim Kee Don Choi Ho June Song Gin Hyug Lee JinHo Kim
Publish Date: 2013/12/06
Volume: 28, Issue: 4, Pages: 1256-1262
Abstract
Endoscopic forceps biopsy EFB is a major diagnostic procedure for gastric epithelial neoplasia GEN However discrepancy between the result of EFB and endoscopic resection ER is not uncommon Thus there is controversy over whether specimens obtained by EFB are optimal for diagnosis of GEN We investigated the discrepancy between EFB and ER in the diagnosis of GENA total of 1850 GEN cases were histologically diagnosed with EFB including 954 lowgrade dysplasias LGDs 315 highgrade dysplasias HGDs and 581 carcinomas Following diagnosis with EFB all patients were treated with ER We retrospectively reviewed the pathologic findings and patient characteristics and analyzed predictors for the discrepancy between the two procedures largest diameter number of biopsy fragments number of biopsy fragments/largest diameter location macroscopic type color surface unevenness and erosionThe overall discrepancy rate between EFB and ER was 317 587/1850 Among the discordant group 440 239 cases showed a higher grade of disease after ER 229 of the 954 LGDs 240 were diagnosed as HGD or carcinoma 166 of the 315 HGDs 527 as carcinoma and 45 of the 581 differentiated carcinomas 77 as undifferentiated carcinoma In the LGD group with EFB the largest diameter ≥18 cm P 0001 surface unevenness P = 0014 and depressed macroscopic type P 0001 were factors associated with discrepancy In the carcinoma group with EFB flat macroscopic type P = 0043 was the only significant factor In the HGD group with EFB there were no significant factors for discrepancyEFB can be insufficient for diagnosing GENs and ER can be considered not only as treatment but also as a diagnostic modality in GEN It is especially pertinent to all cases of HGD regardless of their endoscopic features and to cases of LGDs with the largest lesion diameter ≥18 cm surface unevenness or a depressed macroscopic typeDrs Hyun Lim HwoonYong Jung Young Soo Park Hee Kyong Na Ji Yong Ahn Ji Young Choi Jeong Hoon Lee MiYoung Kim KwiSook Choi Do Hoon Kim Kee Don Choi Ho June Song Gin Hyug Lee and JinHo Kim have no conflicts of interest or financial ties to disclose
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