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

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dc.contributor.authorNoh, CK-
dc.contributor.authorJung, MW-
dc.contributor.authorShin, SJ-
dc.contributor.authorAhn, JY-
dc.contributor.authorCho, HJ-
dc.contributor.authorYang, MJ-
dc.contributor.authorKim, SS-
dc.contributor.authorLim, SG-
dc.contributor.authorLee, D-
dc.contributor.authorKim, YB-
dc.contributor.authorCheong, JY-
dc.contributor.authorLee, KM-
dc.contributor.authorYoo, BM-
dc.contributor.authorLee, KJ-
dc.date.accessioned2020-11-17T05:29:37Z-
dc.date.available2020-11-17T05:29:37Z-
dc.date.issued2019-
dc.identifier.issn1590-8658-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/19071-
dc.description.abstractBACKGROUND 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.
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dc.language.isoen-
dc.subject.MESHAdenocarcinoma-
dc.subject.MESHAdenoma-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHBiopsy-
dc.subject.MESHDisease Progression-
dc.subject.MESHEndoscopic Mucosal Resection-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHLongitudinal Studies-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHStomach Neoplasms-
dc.subject.MESHYoung Adult-
dc.titleAnalysis of endoscopic features for histologic discrepancies between biopsy and endoscopic submucosal dissection in gastric neoplasms: 10-year results-
dc.typeArticle-
dc.identifier.pmid30236767-
dc.subject.keywordAdenoma-
dc.subject.keywordBiopsy-
dc.subject.keywordEndoscopic submucosal dissection-
dc.subject.keywordHistology-
dc.contributor.affiliatedAuthor노, 충균-
dc.contributor.affiliatedAuthor신, 성재-
dc.contributor.affiliatedAuthor조, 효정-
dc.contributor.affiliatedAuthor양, 민재-
dc.contributor.affiliatedAuthor김, 순선-
dc.contributor.affiliatedAuthor임, 선교-
dc.contributor.affiliatedAuthor이, 다근-
dc.contributor.affiliatedAuthor김, 영배-
dc.contributor.affiliatedAuthor정, 재연-
dc.contributor.affiliatedAuthor이, 기명-
dc.contributor.affiliatedAuthor유, 병무-
dc.contributor.affiliatedAuthor이, 광재-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.dld.2018.08.027-
dc.citation.titleDigestive and liver disease-
dc.citation.volume51-
dc.citation.number1-
dc.citation.date2019-
dc.citation.startPage79-
dc.citation.endPage85-
dc.identifier.bibliographicCitationDigestive and liver disease, 51(1). : 79-85, 2019-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1878-3562-
dc.relation.journalidJ015908658-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Gastroenterology
Journal Papers > School of Medicine / Graduate School of Medicine > Pathology
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