TY - JOUR
T1 - Endoscopic characteristics of gastric adenomas suggesting carcinomatous transformation
AU - Jung, Min Kyu
AU - Jeon, Seong Woo
AU - Park, Soo Young
AU - Cho, Chang Min
AU - Tak, Won Young
AU - Kweon, Young Oh
AU - Kim, Sung Kook
AU - Choi, Yong Hwan
AU - Bae, Han Ik
PY - 2008/12
Y1 - 2008/12
N2 - Background: Currently, endoscopic resections, including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), are widely performed for the management of gastric neoplasia. This study aimed to evaluate the potential predictive factors for carcinomas on the basis of endoscopic features. Methods: This study investigated 114 samples from 114 patients. Gastric adenoma was diagnosed initially for all the patients. The endoscopic findings were reviewed for location, size, gross appearance, surface nodularity, ulceration, surface color, and number of biopsy samples. These variables were analyzed and compared between an adenoma group (51 cases) and a carcinoma group (63 cases) on the basis of postresection diagnosis. Results: The mean age of the patients was 62 years (range, 43-82 years), and 83 of the patients were men. The diameter of the lesions was 14.6 ± 8.2 mm in the adenoma group and 15.4 ± 7.4 mm in the carcinoma group. Depressed type, combined high-grade dysplasia, red discoloration, and mucosal ulceration were significant variables associated with carcinomas. In the multivariate analysis, combined high-grade dysplasia was a significant independent predictor of carcinomas. Conclusions: The results suggest that patients with high-grade dysplasia on forceps biopsies should be considered candidates for endoscopic resection. Characteristics of gastric adenomas such as a depressed type, red color, and ulceration that may have foci of carcinomas in other parts of the adenomas also should be considered for endoscopic resection.
AB - Background: Currently, endoscopic resections, including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), are widely performed for the management of gastric neoplasia. This study aimed to evaluate the potential predictive factors for carcinomas on the basis of endoscopic features. Methods: This study investigated 114 samples from 114 patients. Gastric adenoma was diagnosed initially for all the patients. The endoscopic findings were reviewed for location, size, gross appearance, surface nodularity, ulceration, surface color, and number of biopsy samples. These variables were analyzed and compared between an adenoma group (51 cases) and a carcinoma group (63 cases) on the basis of postresection diagnosis. Results: The mean age of the patients was 62 years (range, 43-82 years), and 83 of the patients were men. The diameter of the lesions was 14.6 ± 8.2 mm in the adenoma group and 15.4 ± 7.4 mm in the carcinoma group. Depressed type, combined high-grade dysplasia, red discoloration, and mucosal ulceration were significant variables associated with carcinomas. In the multivariate analysis, combined high-grade dysplasia was a significant independent predictor of carcinomas. Conclusions: The results suggest that patients with high-grade dysplasia on forceps biopsies should be considered candidates for endoscopic resection. Characteristics of gastric adenomas such as a depressed type, red color, and ulceration that may have foci of carcinomas in other parts of the adenomas also should be considered for endoscopic resection.
KW - Endoscopic mucosal resection
KW - Endoscopic submucosal dissection
KW - Gastric adenocarcinoma
KW - Gastric adenoma
KW - Gastric polyp
UR - http://www.scopus.com/inward/record.url?scp=56349145115&partnerID=8YFLogxK
U2 - 10.1007/s00464-008-9875-2
DO - 10.1007/s00464-008-9875-2
M3 - Article
C2 - 18401651
AN - SCOPUS:56349145115
SN - 0930-2794
VL - 22
SP - 2705
EP - 2711
JO - Surgical Endoscopy and Other Interventional Techniques
JF - Surgical Endoscopy and Other Interventional Techniques
IS - 12
ER -