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Gastric Cancer

, Volume 20, Issue 4, pp 671–678

First Online: 07 November 2016Received: 04 August 2016Accepted: 24 October 2016DOI: 10.1007-s10120-016-0665-6

Cite this article as: Ryu, D.G., Choi, C.W., Kang, D.H. et al. Gastric Cancer 2017 20: 671. doi:10.1007-s10120-016-0665-6

Abstract

Background and study aimsAlthough the Vienna Classification recommends endoscopic resection for gastric high-grade dysplasia HGD, many resected lesions are diagnosed as gastric cancer after endoscopic resection. This study aims to evaluate the clinical outcomes of gastric HGD identified by endoscopic forceps biopsy EFB after endoscopic submucosal dissection ESD and factors associated with discrepant results.

Patients and methodsFrom December 2008 to July 2015, a total of 427 lesions diagnosed as initial HGD by EFB were enrolled. The rate of early gastric cancer EGC and factors predicting diagnosis upgrade were analyzed retrospectively.

ResultsTumors ranged between 2 and 65 mm in size median 12.59. En bloc and complete resection rates were 97.4 and 95.3%, respectively. The diagnostic discrepancy rate was 76.3%. Upgrade and downgrade rates of pathological diagnoses were 66.5 and 9.8%, respectively. Central depression OR 4.151, nodular surface OR 5.582, surface redness OR 2.926, lesion location upper third of the stomach OR 3.894, and tumor size ≥10 mm OR 2.287 were significantly associated with EGC. Nodular surface OR 2.746, submucosal fibrosis OR 3.958, lesion location upper third of the stomach OR 6.652, and tumor size ≥10 mm OR 4.935 significantly predicted invasive submucosal cancer.

ConclusionsCentral depression, nodular surface, surface redness, lesion location, large tumor size, and submucosal fibrosis were associated with EGC or submucosal cancer. Caution must be used in treating lesions with these features with ESD.

KeywordsEarly gastric cancer Dysplasia Endoscopic submucosal dissection Biopsy 



Author: Dae Gon Ryu - Cheol Woong Choi - Dae Hwan Kang - Hyung Wook Kim - Su Bum Park - Su Jin Kim - Hyeong Seok Nam

Source: https://link.springer.com/







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