Non-neoplastic pathology results after endoscopic submucosal dissection for gastric epithelial dysplasia or early gastric cancer.
Endoscopy
; 47(7): 598-604, 2015 Jul.
Article
em En
| MEDLINE
| ID: mdl-25650637
ABSTRACT
BACKGROUND AND STUDY AIMS:
Endoscopists sometimes face paradoxical cases in which the endoscopic submucosal dissection (ESD) specimen reveals a non-neoplastic pathology result. The aims of the study were to determine the reasons for such results, and to compare the endoscopic characteristics of non-neoplastic and conventional neoplastic pathology groups after ESD. PATIENTS ANDMETHODS:
A total of 1186 gastric ESDs performed between February 2005 and December 2011 were retrospectively reviewed. The ESD specimens included 52 (4.4â%) that were confirmed as negative or indefinite for neoplasia. Patient characteristics and endoscopic and pathological data were reviewed and compared.RESULTS:
Non-neoplastic pathology after ESD was due to complete removal of the lesion at biopsy in 45 cases (86.5â%), pathology overestimation in 5 (9.6â%), and incorrect localization of the original tumor with subsequent ESD performed at the wrong site in 2 (3.8â%). The mean length and surface area of the non-neoplastic lesions were 9.2â±â2.6âmm and 49.6â±â23.6âmmâ(2), respectively. Mean sampling ratios were 3.0â±â1.5âmm/fragment and 16.3â±â10.0âmm(2)/fragment. Compared with 1134 cases confirmed as neoplastic on the final ESD specimen, non-neoplastic cases showed a significantly smaller tumor size and surface area, and lower sampling ratios in a logistic regression analysis adjusted for potential confounders (Pâ<â0.001 for all).CONCLUSIONS:
Complete lesion removal by biopsy, pathology overestimation, and incorrect localization of the original tumor with subsequent ESD at the wrong site were the main reasons for non-neoplastic results after ESD. Small tumor size and surface area, and low sampling ratios were associated with non-neoplastic pathology results after ESD.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Gástricas
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Adenocarcinoma
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Adenoma
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Gastroscopia
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Dissecação
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Mucosa Gástrica
Tipo de estudo:
Evaluation_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Endoscopy
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Coréia do Sul