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Endoscopic characteristics of gastric adenomas suggesting carcinomatous transformation

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Abstract

Background

Currently, endoscopic resections, including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), are widely performed for the management of gastric neoplasia. This study aimed to evaluate the potential predictive factors for carcinomas on the basis of endoscopic features.

Methods

This study investigated 114 samples from 114 patients. Gastric adenoma was diagnosed initially for all the patients. The endoscopic findings were reviewed for location, size, gross appearance, surface nodularity, ulceration, surface color, and number of biopsy samples. These variables were analyzed and compared between an adenoma group (51 cases) and a carcinoma group (63 cases) on the basis of postresection diagnosis.

Results

The mean age of the patients was 62 years (range, 43–82 years), and 83 of the patients were men. The diameter of the lesions was 14.6 ± 8.2 mm in the adenoma group and 15.4 ± 7.4 mm in the carcinoma group. Depressed type, combined high-grade dysplasia, red discoloration, and mucosal ulceration were significant variables associated with carcinomas. In the multivariate analysis, combined high-grade dysplasia was a significant independent predictor of carcinomas.

Conclusions

The results suggest that patients with high-grade dysplasia on forceps biopsies should be considered candidates for endoscopic resection. Characteristics of gastric adenomas such as a depressed type, red color, and ulceration that may have foci of carcinomas in other parts of the adenomas also should be considered for endoscopic resection.

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Authors and Affiliations

  1. Department of Internal Medicine, Kyungpook National University Hospital, 50 Samduk 2-Ga, Chung-gu, Daegu, 700-721, South Korea

    Min Kyu Jung, Seong Woo Jeon, Soo Young Park, Chang Min Cho, Won Young Tak, Young Oh Kweon, Sung Kook Kim & Yong Hwan Choi

  2. Department of Pathology, Kyungpook National University Hospital, 50 Samduk 2-Ga, Chung-gu, Daegu, 700-721, South Korea

    Han Ik Bae

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  1. Min Kyu Jung
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Correspondence to Seong Woo Jeon.

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Jung, M.K., Jeon, S.W., Park, S.Y. et al. Endoscopic characteristics of gastric adenomas suggesting carcinomatous transformation. Surg Endosc 22, 2705–2711 (2008). https://doi.org/10.1007/s00464-008-9875-2

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  • DOI: https://doi.org/10.1007/s00464-008-9875-2

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