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Analysis of endoscopic features for histologic discrepancies between biopsy and endoscopic submucosal dissection in gastric neoplasms: 10-year results

Noh, CK  | Jung, MW | Shin, SJ  | Ahn, JY | Cho, HJ  | Yang, MJ  | Kim, SS  | Lim, SG  | Lee, D  | Kim, YB  | Cheong, JY  | Lee, KM  | Yoo, BM  | Lee, KJ
Digestive and liver disease, 51(1). : 79-85, 2019
Journal Title
Digestive and liver disease
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 <1cm 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.


Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
Ajou Authors
김, 순선  |  김, 영배  |  노, 충균  |  신, 성재  |  양, 민재  |  유, 병무  |  이, 광재  |  이, 기명  |  이, 다근  |  임, 선교  |  정, 재연  |  조, 효정
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