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Risk factors associated with diagnostic discrepancy of gastric indefinite neoplasia: Who need en bloc resection?

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Abstract

Background

Endoscopic forceps biopsy is insufficient for a definitive diagnosis of dysplastic lesions. It is difficult to decide clinical management of gastric indefinite neoplasia diagnosed by endoscopic forceps biopsy when early gastric cancer (EGC) is macroscopically suspected. The aim of this study was to discuss the final results of gastric indefinite neoplasia and associated clinical factors predictive of early gastric cancer.

Methods

The medical records of 119 patients who were diagnosed with gastric indefinite neoplasia by index forceps biopsy were retrospectively reviewed. The initial endoscopic findings were analyzed, and predictive factors of EGC were evaluated.

Results

The final pathologic diagnoses of 119 patients included early gastric cancer (n = 26, 21.8 %), adenoma (n = 6, 5.0 %) and non-neoplasm (n = 87, 73.1 %). Univariate analysis showed that lesion size greater than 10 mm, surface nodularity and surface redness were associated risk factors. In the multivariate analysis, lesions diameter (p = 0.021, OR 11.401, 95 % CI 1.432–90.759) and surface redness (p = 0.014, OR 3.777, 95 % CI 1.306–10.923) were significant risk factors.

Conclusions

Patients with gastric indefinite neoplasia with larger size (≥10 mm) and surface redness might need further diagnostic investigation rather than simple follow-up endoscopy.

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Disclosures

Goo Ja Jun, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park, Mong Cho, Sun Hwi Hwang and Si Hak Lee have no conflicts of interest or financial ties to disclose.

Acknowledgments

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by Ministry for Health & Welfare, Republic of Korea (grant number: HI12C1845).

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Authors and Affiliations

  1. Department of Internal Medicine, Medical Research Institute, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Beomeo-ri, Mulgeum-eup, Yangsan, Gyeongsangnam-do, 626-770, Korea

    Ja Jun Goo, Cheol Woong Choi, Dae Hwan Kang, Hyung Wook Kim, Su Bum Park & Mong Cho

  2. Department of Surgery, Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Korea

    Su Bum Park, Sun Hwi Hwang & Si Hak Lee

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  1. Ja Jun Goo
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  2. Cheol Woong Choi
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  3. Dae Hwan Kang
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  4. Hyung Wook Kim
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Correspondence to Cheol Woong Choi.

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Goo, J.J., Choi, C.W., Kang, D.H. et al. Risk factors associated with diagnostic discrepancy of gastric indefinite neoplasia: Who need en bloc resection?. Surg Endosc 29, 3761–3767 (2015). https://doi.org/10.1007/s00464-015-4151-8

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  • DOI: https://doi.org/10.1007/s00464-015-4151-8

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