Discrepancy between endoscopic and pathological ulcerative findings in clinical intramucosal early gastric cancer
| Autor: | Kinichi Hotta, Hirotoshi Ishiwatari, Hiroyuki Matsubayashi, Kohei Takizawa, Etsuro Bando, Noboru Kawata, Takashi Sugino, Hiroyuki Ono, Yohei Yabuuchi, Yoshihiro Kishida, Naomi Kakushima, Kenichiro Imai, Yoichi Yamamoto, Masao Yoshida, Masanori Terashima, Sayo Ito |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Endoscopic Mucosal Resection Gastroenterology Lesion 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Stomach Neoplasms Internal medicine medicine Humans Prospective Studies Risk factor Pathological Aged business.industry Stomach General Medicine Odds ratio Confidence interval Early Gastric Cancer medicine.anatomical_structure Oncology Gastric Mucosa 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Female medicine.symptom business Abdominal surgery |
| Zdroj: | Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association. 24(3) |
| ISSN: | 1436-3305 |
| Popis: | Ulcerative finding (UL) is one of the factors that define the indication and curability of endoscopic resection (ER) in early gastric cancer (EGC). Discrepancies between endoscopic UL (cUL) and pathological UL (pUL) sometimes occur in clinical practice. The aim of this study was to investigate the discrepancy rate in UL diagnosis and the risk factors associated with such discrepancies. Patients with clinical intramucosal (cT1a) EGC who underwent ER or surgery between September 2002 and December 2017 were analyzed. The proportion of cUL-negative (cUL0) lesions that were identified as pUL-positive (pUL1) and that of cUL-positive (cUL1) lesions that were identified as pUL-negative (pUL0) were calculated. Logistic regression analysis was performed to estimate the associations between discrepancy in UL diagnosis and clinical variables of the lesion, such as the size, histology, location, and macroscopic type. In total, 5382 lesions were evaluated; 5.5% of cUL0 lesions (256/4619) were identified as pUL1, while 38.7% of cUL1 lesions (295/763) were pUL0. Multivariate analysis indicated that in cUL1 lesions, tumor location in the lower third of the stomach (odds ratio 3.11, 95% confidence interval 1.90–5.08) was identified as an independent risk factor for overestimation. Endoscopic diagnosis of UL in cT1a EGC was overestimated in 38.7% of lesions, especially for lesions located in the lower third of the stomach. This discrepancy should be considered in the management of cT1a EGC with UL. |
| Databáze: | OpenAIRE |
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