Risk factors associated with diagnostic discrepancy of gastric indefinite neoplasia: Who need en bloc resection?

Goo, Ja Jun; Choi, Cheol Woong; Kang, Dae Hwan; Kim, Hyung Wook; Park, Su Bum; Cho, Mong; Hwang, Sun-Hwi; Lee, Si Hak

doi:10.1007/s00464-015-4151-8

Cited by 16 publications

(14 citation statements)

References 18 publications

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“…In previous studies about dysplasia, endoscopic findings with lesion size greater than 2 cm, 7 presence of ulcer, depressed morphology, 19 and hemorrhagic tendency 13 have strongly suggested high-grade adenoma or gastric cancer. 20 In revised Vienna classification category 2, lesion greater than 1 cm in diameter and surface discoloration were risk factors for carcinoma.…”

Section: Discussionmentioning

confidence: 96%

“…In a previous study, 21.8% (26/119) of indefinite neoplasia (category 2) were also confirmed to be gastric cancer. 7 Therefore, atypical gland can be a diagnosis of broad spectrum from benign inflammatory lesion to cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have dealt with clinical significance of indefinite neoplasia (category 2), including atypical gland. 3 , 7 , 8 Precise diagnosis and grading of dysplasia are important in determining the treatment strategy. Although several studies have recommended further evaluation such as big size re-biopsy for strongly suspicious lesion of malignancy, 8 , 13 , 19 endoscopic resection can be a modality for definite diagnosis and treatment of atypical gland.…”

Section: Discussionmentioning

confidence: 99%

“… 20 In revised Vienna classification category 2, lesion greater than 1 cm in diameter and surface discoloration were risk factors for carcinoma. 7 However, previous studies have focused on general endoscopic findings of patients with dysplasia or inflammatory lesions such as regenerative atypism/atypia, instead of focusing on atypical glands only. In this study, only patients with atypical glands from initial gastric biopsy were included.…”

Section: Discussionmentioning

confidence: 99%

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Clinical Implication and Risk Factors for Malignancy of Atypical Gastric Gland during Forceps Biopsy

Kim

Kim²,

Lee³

et al. 2018

Gut and Liver

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Background/AimsAlthough forceps biopsy is performed for suspicious gastric tumors during endoscopy, it is difficult to determine treatment strategies for atypical gastric glands due to uncertainty of the diagnosis. The aim of this study was to investigate clinical implications and risk factors for predicting malignancy in atypical gastric glands during forceps biopsy.MethodsWe retrospectively reviewed medical records of 252 patients with a diagnosis of atypical gastric gland during forceps biopsy. Predictors of malignancy were analyzed using initial endoscopic findings and clinical data.ResultsThe final diagnosis for 252 consecutive patients was gastric cancer in 189 (75%), adenoma in 26 (10.3%), and gastritis in 37 (14.7%). In the multivariate analysis, lesion sizes of more than 10 mm (odds ratio [OR], 3.021; 95% confidence interval [CI], 1.480 to 6.165; p=0.002), depressed morphology (OR, 3.181; 95% CI, 1.579 to 6.406, p=0.001), and surface nodularity (OR, 3.432; 95% CI, 1.667 to 7.064, p=0.001) were significant risk factors for malignancy.ConclusionsFurther evaluation and treatment should be considered for atypical gastric gland during forceps biopsy if there is a large-sized (>10 mm) lesion, depressed morphology, or surface nodularity.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Implication and Risk Factors for Malignancy of Atypical Gastric Gland during Forceps Biopsy

Kim

Kim²,

Lee³

et al. 2018

Gut and Liver

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“…Among gastric indefinite neoplasia from endoscopic forceps biopsy, 21.8% of the lesions were diagnosed as EGC during follow-up. [ 27 ] Therefore, follow-up endoscopic examinations and repeated endoscopic forceps biopsy are necessary for suspicious neoplastic lesions. Regular surveillance examination is important to detect overlooked synchronous lesions before progressing to invasive cancers.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of overlooked synchronous gastric epithelial neoplasia after endoscopic submucosal dissection

et al. 2018

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Since endoscopic submucosal dissection (ESD) has been accepted as the treatment of choice for early gastric cancer (EGC) without risk of lymph node metastasis, synchronous gastric epithelial neoplasia is no longer rare in the clinical practice. Knowledge about the characteristics associated with synchronous gastric epithelial neoplasia is of great importance to prevent delayed diagnosis.Between November 2008 and December 2014, a retrospective study was conducted in a single tertiary referral hospital. Consecutive patients who underwent ESD due to EGC or high-grade dysplasia were analyzed to evaluate the incidence of synchronous gastric epithelial neoplasia and the factors associated with synchronous and overlooked synchronous lesions.A total of 488 patients were analyzed in this study. Synchronous lesions were found in 59 patients (12.1%) during the mean 37.7 months of follow-up. Among 77 synchronous lesions, 25 lesions (32.4%) were overlooked at the time of initial ESD. Age of ≥ 65 years, moderate to severe endoscopic atrophic gastritis, and elevated morphology of primary lesions were associated with synchronous gastric epithelial neoplasia. An important factor associated with overlooked lesions is the non-elevated morphology of lesions.Careful endoscopic examination of the whole stomach is necessary in patients who are older and who have moderate to severe atrophic gastritis and elevated morphology of lesions to prevent delayed diagnosis of synchronous gastric epithelial neoplasia, especially non-elevated lesions.

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Endoscopic submucosal dissection for gastric indefinite for neoplasia: which lesions should be resected?

et al. 2019

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Risk factors associated with diagnostic discrepancy of gastric indefinite neoplasia: Who need en bloc resection?

Abstract: Patients with gastric indefinite neoplasia with larger size (≥10 mm) and surface redness might need further diagnostic investigation rather than simple follow-up endoscopy.

Cited by 16 publications

References 18 publications

Clinical Implication and Risk Factors for Malignancy of Atypical Gastric Gland during Forceps Biopsy

Clinical Implication and Risk Factors for Malignancy of Atypical Gastric Gland during Forceps Biopsy

Characteristics of overlooked synchronous gastric epithelial neoplasia after endoscopic submucosal dissection

Endoscopic submucosal dissection for gastric indefinite for neoplasia: which lesions should be resected?

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