Endoscopic Resection as a First Therapy for Gastric Epithelial Atypia: Is It Reasonable?
| Autor: | Jun Heo, Hyun Seok Lee, Gyu Young Kim, Sun Zoo Kim, Han Ik Bae, Chung Hoon Yu, Yong Hwan Kwon, Seong Woo Jeon, Sung Kook Kim |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Physiology Endoscopic mucosal resection Sensitivity and Specificity Lesion Predictive Value of Tests Risk Factors Stomach Neoplasms Gastroscopy Biopsy Odds Ratio Humans Medicine Aged Retrospective Studies Univariate analysis medicine.diagnostic_test business.industry Gastroenterology Odds ratio Middle Aged medicine.disease Surgery Gastric Mucosa Dysplasia Predictive value of tests Female Radiology medicine.symptom business Precancerous Conditions Gastric Neoplasm |
| Zdroj: | Digestive Diseases and Sciences. 59:3012-3020 |
| ISSN: | 1573-2568 0163-2116 |
| Popis: | 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. 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. 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. 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. |
| Databáze: | OpenAIRE |
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