Histological comparison of endoscopic forceps biopsy with endoscopic mucosal resection in the gastric lesions / 대한내과학회지

ABSTRACT

BACKGROUND: The correct histological diagnosis of a gastric adenoma is important, because an adenoma has been reported to be a precancerous lesion and is associated with focal gastric carcinoma. However, there is some discrepancy between the histology of a forceps biopsy and that of the endoscopic mucosal resection. This study compared the histological findings of a gastric mucosal lesion in the specimens of a forceps biopsy and an endoscopic mucosal resection. METHODS: 88 cases of gastric mucosal lesions, which had been removed by the endoscopic mucosal resection, were reviewed retrospectively. All the patients had undergone a forceps biopsy before the endoscopic mucosal resection. The histological findings of the specimens by a forceps biopsy were compared with those by resection. RESULTS: The histological findings were accordant at 52 of the 88 cases (59.1%). Among the 71 cases with adenoma or gastritis in the biopsied specimens, 13 cases (18.3%) were finally diagnosed with gastric cancer in the resected specimens. Among all the gastritis and adenomas determined by the forceps biopsy, the high-risk groups for adenocarcinomas were characterized by the following endoscopic findings: red-colored and depressed lesions. CONCLUSIONS: Biopsy specimens may not be representative of the entire lesion. Therefore, an endoscopic resection of a gastric mucosal lesion is needed for making an accurate histological diagnosis and treatment if adenomas such as red-colored or depressed lesions are suspected.