Kosin Med J.  2014 Dec;29(2):117-124. 10.7180/kmj.2014.29.2.117.

Pathological differences between forceps biopsy specimens and endoscopic resection specimens in early gastric cancer patients

• Kim JS
• Kim SH
• Kim MG
• Ryu AJ
• Ryu IH
• Lee JJ
• Jeon JW
• Choi JW
• Kim A

• KMID: 2308496
• DOI: http://doi.org/10.7180/kmj.2014.29.2.117

Abstract

OBJECTIVE
Endoscopic resection(ER) is effective therapy on EGC and which is treated according to the histological diagnosis of forcep biopsy. But sometimes the histological diagnosis of forcep biopsy and post-ER does not match with each other and it might lead to wrong treatment. The aim of this study is to find the frequency of histologic differences between forcep biopsy and post-ER, and to confirm the characteristics of lesions which make errors.
METHODS
We selected the confirmed cancer cases of 141 patients of 1359 gastric tumor lesions which were treated under the ER in Eulji university hospital from May 2005 to March 2013. They were sorted by the age and sex of patient, location of lesion, present of ulcer and depression to identify the discordance between forcep biopsy and ER. The discordant group was compared with non-cancer-diagnosed controlled group, retrospectively.
RESULTS
70 cases(5.5%) of 1283 cases of "cancer negative" in forceps biopsy were found to be diagnosed cancer on final diagnosis of cancer by post-ER result. In this discordant group showed characteristics of bigger size that are with more frequently in tumor size >==15mm(17.9% vs. 31.4%, p=0.03), have depressed lesion(14.3% vs. 41.4%, p<0.01) and have ulceration(2.4% vs.18.6%, p<0.01) than that of 84 control group not diagnosed cancer.
CONCLUSIONS
In cases of tumor with size >==15mm, presented with depressed lesion and ulceration, we should consider combined cancer, even the result of forcep biopsy was negative. Therefore, more careful and accurate resection should be taken with characters listed above.

Keyword

Differences; Early gastric cancer; Endoscopic resection; Forcep biopsy; Histologic

MeSH Terms

Biopsy*
Depression
Diagnosis
Humans
Retrospective Studies
Stomach Neoplasms*
Surgical Instruments*
Ulcer

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