Erschienen in:
01.12.2014 | Original Article
Endoscopic Resection as a First Therapy for Gastric Epithelial Atypia: Is It Reasonable?
verfasst von:
Chung Hoon Yu, Seong Woo Jeon, Sung Kook Kim, Hyun Seok Lee, Jun Heo, Yong Hwan Kwon, Gyu Young Kim, Sun Zoo Kim, Han Ik Bae
Erschienen in:
Digestive Diseases and Sciences
|
Ausgabe 12/2014
Einloggen, um Zugang zu erhalten
Abstract
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.