Endoscopic predictors for undifferentiated histology in differentiated gastric neoplasms prior to endoscopic resection View Full Text


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Article Info

DATE

2015-03-27

AUTHORS

Ji Min Choi, Sang Gyun Kim, Hyo-Joon Yang, Joo Hyun Lim, Jeongmin Choi, Jong Pil Im, Joo Sung Kim, Woo Ho Kim, Hyun Chae Jung

ABSTRACT

BackgroundThere is often a discrepancy between results from endoscopic forceps biopsy and resected specimen. We aimed to identify endoscopic predictors for undifferentiated histology in differentiated gastric neoplasms prior to endoscopic resection.MethodsMedical records of the patients who underwent endoscopic submucosal dissection (ESD) for biopsy-proven differentiated gastric neoplasms at Seoul National University Hospital between July 2005 and July 2014 were retrospectively reviewed. The lesions were divided into two groups based on the final histologic result of ESD: differentiated adenocarcinoma (DA group) and undifferentiated histology (UDH group). The discordant rate, clinicopathologic characteristics, and endoscopic factors were analyzed.ResultsA total of 1641 early gastric cancers from 1615 patients were included. Of these, 1556 (94.8 %) were diagnosed as DA and 85 (5.2 %) as UDH. The mean age was significantly lower, and number of women was higher in the UDH group than in the DA group. On multivariate analysis, age <65 years [odds ratio (OR) 1.75, 95 % confidence interval (CI) 1.10–2.80], female sex (OR 3.19, 95 % CI 2.00–5.08), endoscopic size >10 mm (OR 1.81, 95 % CI 1.12–2.92), depressed type (OR 2.85, 95 % CI 1.56–5.21), nodularity (OR 2.83, 95 % CI 1.59–5.05), and whitish discoloration (OR 19.64, 95 % CI 6.98–55.25) were independent predictors.ConclusionsFemale sex, age <65 years, large endoscopic size, depressed morphology, surface nodularity, and whitish discoloration were predictors for UDH. Meticulous attention should be paid to the lesions with these endoscopic predictors for determining the risk of UDH prior to endoscopic resection. More... »

PAGES

89-98

References to SciGraph publications

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    http://scigraph.springernature.com/pub.10.1007/s00464-015-4165-2

    DOI

    http://dx.doi.org/10.1007/s00464-015-4165-2

    DIMENSIONS

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    34 schema:description BackgroundThere is often a discrepancy between results from endoscopic forceps biopsy and resected specimen. We aimed to identify endoscopic predictors for undifferentiated histology in differentiated gastric neoplasms prior to endoscopic resection.MethodsMedical records of the patients who underwent endoscopic submucosal dissection (ESD) for biopsy-proven differentiated gastric neoplasms at Seoul National University Hospital between July 2005 and July 2014 were retrospectively reviewed. The lesions were divided into two groups based on the final histologic result of ESD: differentiated adenocarcinoma (DA group) and undifferentiated histology (UDH group). The discordant rate, clinicopathologic characteristics, and endoscopic factors were analyzed.ResultsA total of 1641 early gastric cancers from 1615 patients were included. Of these, 1556 (94.8 %) were diagnosed as DA and 85 (5.2 %) as UDH. The mean age was significantly lower, and number of women was higher in the UDH group than in the DA group. On multivariate analysis, age <65 years [odds ratio (OR) 1.75, 95 % confidence interval (CI) 1.10–2.80], female sex (OR 3.19, 95 % CI 2.00–5.08), endoscopic size >10 mm (OR 1.81, 95 % CI 1.12–2.92), depressed type (OR 2.85, 95 % CI 1.56–5.21), nodularity (OR 2.83, 95 % CI 1.59–5.05), and whitish discoloration (OR 19.64, 95 % CI 6.98–55.25) were independent predictors.ConclusionsFemale sex, age <65 years, large endoscopic size, depressed morphology, surface nodularity, and whitish discoloration were predictors for UDH. Meticulous attention should be paid to the lesions with these endoscopic predictors for determining the risk of UDH prior to endoscopic resection.
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    42 ConclusionsFemale sex
    43 DA
    44 DA group
    45 MethodsMedical records
    46 National University Hospital
    47 ResultsA total
    48 Seoul National University Hospital
    49 UDH
    50 UDH group
    51 University Hospital
    52 adenocarcinoma
    53 age
    54 analysis
    55 attention
    56 biopsy
    57 biopsy-proven differentiated gastric neoplasms
    58 cancer
    59 characteristics
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    61 depressed morphology
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    64 discoloration
    65 discordant rate
    66 discrepancy
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    69 endoscopic factors
    70 endoscopic forceps biopsy
    71 endoscopic predictors
    72 endoscopic resection
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    75 factors
    76 female sex
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    79 gastric cancer
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    81 group
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    84 hospital
    85 independent predictors
    86 large endoscopic size
    87 lesions
    88 mean age
    89 meticulous attention
    90 morphology
    91 multivariate analysis
    92 neoplasms
    93 nodularity
    94 number
    95 number of women
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    99 records
    100 resected specimen
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    105 sex
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    109 surface nodularity
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