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Background:Prognosis of early colorectal carcinoma( ECC)is well because of low rate of lymph-node metastasis ( LNM). How to improve the detection rate and select appropriate therapy for ECC has been an eager task in clinical practice. Aims:To analyze the pathological features of ECC treated by endoscopic resection(ER)or surgery,and evaluate the therapeutic efficacy of ER. Methods:Pathological data of 503 ECC lesions treated by ER or surgery were retrospectively analyzed. Risk factors of infiltration depth,LNM of ECC were analyzed,and therapeutic efficacy of ER was evaluated. Results:The overall detection rate of ECC was 10. 7%. The incidence of LNM was 1. 2%(6/503);the LNM incidence of mucosal high-grade neoplasia was 0%( 0/247 ),while was 2. 3%( 6/256 ) in submucosal carcinoma. The LNM incidence of submucosal superficial carcinoma treated by ER was 0%( 0/31 ). Tumor location, size,histological type and LNM had significant impacts on infiltration depth(P<0. 05). The rates of en bloc,complete and curative resection by ER were 96. 0%,94. 2% and 82. 1%,respectively. Infiltration depth was the risk factor of piecemeal,incomplete and noncurative resection of ER(P<0. 05). Conclusions:The incidence of LNM in ECC is extremely low. Accurate evaluation of character and infiltration depth of lesion before operation is helpful for selecting appropriate therapy. It should be cautious to choose ER for lesions infiltrated into submucosa,thereby to improve the therapeutic efficacy of ER.
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Objective To evaluate target biopsy using magnifying endoscopy combined with narrow band imaging(ME-NBI) in suspicious gastric lesions.Methods A total of 113 patients with suspicious early gastric lesions under white light endoscopy(WLE) were prospectively enrolled and biopsied between May 2011 and May 2013.Further endoscopy was conducted using ME-NBI and target biopsy.All patients received endoscopic resection(ER).Outcomes of WLE biopsy and target biopsy were compared,with histology of ER specimen as golden standard.Results The overall diagnostic accuracy of WLE biopsy and target biopsy were 22.1％ (25/113) and 54.0％ (61/113),(P ＜ 0.0001).In diagnosing early gastric cancer (EGC) and high-grade intraepithelial neoplasia (HGIN),the sensitivity of target and WLE biopsy were 70.9％ and 37.9％ (P ＜ O.0001),respectively.The specificity were 90.0％ in both groups.The accuracy rates were 72.6％ and 42.5％,respectively(P ＜0.0001).The positive predictive values were 98.6％ and 97.5％ (P ＞ 0.05).The negative predictive values were 23.1％ and 12.3％ (P ＞ 0.05),respectively.The overall progression rate of target biopsy was 46.9％ (53/113).Conclusion ME-NBI target biopsy is superior to traditional WLE biopsy in diagnosis of early gastric cancer.