TY - JOUR
T1 - Endoscopic Resection as a First Therapy for Gastric Epithelial Atypia
T2 - Is It Reasonable?
AU - Yu, Chung Hoon
AU - Jeon, Seong Woo
AU - Kim, Sung Kook
AU - Lee, Hyun Seok
AU - Heo, Jun
AU - Kwon, Yong Hwan
AU - Kim, Gyu Young
AU - Kim, Sun Zoo
AU - Bae, Han Ik
N1 - Publisher Copyright:
© 2014, Springer Science+Business Media New York.
PY - 2014/11/19
Y1 - 2014/11/19
N2 - Background and Aims: Gastric atypical cell (GAC), an indefinite pathologic finding, often requires repeated biopsy or other diagnostic treatments, such as endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or operation (OP). The aim of this study was to analyze the initial endoscopic and histologic findings of GAC and to discuss the necessity of EMR/ESD at establishing a correct diagnosis.Methods: This retrospective study enrolled 96 patients proven as GAC on index forceps biopsy. ESD (17/96, 17.7 %), EMR (5/96, 5.2 %), OP (20/96, 20.8 %), and other treatment or follow-up (54/96, 56.3 %) were performed. We analyzed the initial endoscopic and histologic characteristics of GAC lesions, predictive of neoplasm.Results: After diagnostic modalities, the final pathologic diagnoses were cancer (36/96, 37.6 %), dysplasia (9/96, 9.4 %), and non-neoplasm (51/96, 53.0 %). In univariate analysis, age [odds ratio (OR) 1.04, 95 % confidence interval (CI) 1.01–1.07], lesion size of 10 mm or greater (OR 3.94, 95 % CI 1.61–9.61), lesion with depressed type (OR 2.50, 95 % CI 1.09–5.72), and presence of H. pylori (OR 2.83, 95 % CI 1.11–7.25) were risk factors for neoplasm. In multivariate analysis, lesion size of 10 mm or greater (OR 3.63, 95 % CI 1.23–10.66), lesion with depressed type (OR 2.86, 95 % CI 1.11–7.38) were independent risk factors for cancer.Conclusion: Considering the neoplastic risk of GAC, which could be missed on biopsy, more comprehensive tissue sampling via EMR/ESD might be necessary to establish a definite diagnosis.
AB - Background and Aims: Gastric atypical cell (GAC), an indefinite pathologic finding, often requires repeated biopsy or other diagnostic treatments, such as endoscopic mucosal resection (EMR), endoscopic submucosal dissection (ESD), or operation (OP). The aim of this study was to analyze the initial endoscopic and histologic findings of GAC and to discuss the necessity of EMR/ESD at establishing a correct diagnosis.Methods: This retrospective study enrolled 96 patients proven as GAC on index forceps biopsy. ESD (17/96, 17.7 %), EMR (5/96, 5.2 %), OP (20/96, 20.8 %), and other treatment or follow-up (54/96, 56.3 %) were performed. We analyzed the initial endoscopic and histologic characteristics of GAC lesions, predictive of neoplasm.Results: After diagnostic modalities, the final pathologic diagnoses were cancer (36/96, 37.6 %), dysplasia (9/96, 9.4 %), and non-neoplasm (51/96, 53.0 %). In univariate analysis, age [odds ratio (OR) 1.04, 95 % confidence interval (CI) 1.01–1.07], lesion size of 10 mm or greater (OR 3.94, 95 % CI 1.61–9.61), lesion with depressed type (OR 2.50, 95 % CI 1.09–5.72), and presence of H. pylori (OR 2.83, 95 % CI 1.11–7.25) were risk factors for neoplasm. In multivariate analysis, lesion size of 10 mm or greater (OR 3.63, 95 % CI 1.23–10.66), lesion with depressed type (OR 2.86, 95 % CI 1.11–7.38) were independent risk factors for cancer.Conclusion: Considering the neoplastic risk of GAC, which could be missed on biopsy, more comprehensive tissue sampling via EMR/ESD might be necessary to establish a definite diagnosis.
KW - Atypical epithelial cells
KW - Endoscopic surgical procedure
KW - Gastric neoplasms
KW - Indefinite pathology
UR - http://www.scopus.com/inward/record.url?scp=84912567981&partnerID=8YFLogxK
U2 - 10.1007/s10620-014-3249-5
DO - 10.1007/s10620-014-3249-5
M3 - Article
C2 - 24927801
AN - SCOPUS:84912567981
SN - 0163-2116
VL - 59
SP - 3012
EP - 3020
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 12
ER -
