(Saturday, 3/30/2019)
Room: Exhibit Hall
Purpose: We aimed at investigating clinicopathological and endoscopic characteristics of early gastric cancer and precancerous lesions, comparing differences in diagnosis between endoscopic forceps biopsy (EFB) and endoscopic submucosal dissection (ESD), and identifying risk factors of under-diagnosis of high-grade intraepithelial neoplasia(HGIN)/carcinoma for a better guidance of the ESD decision making process.
Methods: From June 2015 to November 2018，the 60 patients with gastric mucosal HGIN, and early gastric carcinoma(EGC) which were treated by ESD were include. We reviewed the relationship between lesion area, expression of white light endoscopy, magnification endoscopy, narrowband imaging endoscopy and postoperative pathological classification and depth of lesion was analyzed. Differences in those features between EFB and ESD were compared and risk factors for under-diagnosis by EFB were analyzed.
Results: There were 60 patients with a total of 62 lesions. There was no statistically significant difference between pathological type and lesion part, lesion size. There were statistically significant difference between LGIN and HGIN, severe dysplasia and early gastric cancer in clear boundary, irregular capillaries, irregular surface microstructure. Although concordant in most (91.94%) cases between EFBs and ESDs, pathological diagnoses in 5 (8.06%) cases were upgraded in ESDs. Compared to the concordant group, the lesion size is more than 2 cm, and depressed, excavated and ulcer patterns were signi�cantly more frequent in the upgraded group.
Conclusion: Magnification endoscopy combined with NBI can find early detection of HGIN and early gastric cancer. Preoperative biopsy had guidance significance in diagnosis and treatment, which can reduce the missed diagnosis of early gastric cancer. Lesion size more than 2.0 cm and the depressed pattern at initial EFB were independent risk factors for pathologic upgrade to advanced diseases in ESD.
Contact Email
