Gut Liver.  2018 Sep;12(5):523-529. 10.5009/gnl18006.

Clinical Implication and Risk Factors for Malignancy of Atypical Gastric Gland during Forceps Biopsy

• Kim MS
• Kim SG
• Chung H
• Kim J
• Hong H
• Lee HJ
• Kim HJ
• Kim MA
• Kim WH
• Jung HC

• KMID: 2424080
• DOI: http://doi.org/10.5009/gnl18006

Abstract

BACKGROUND/AIMS
Although forceps biopsy is performed for suspicious gastric tumors during endoscopy, it is difficult to determine treatment strategies for atypical gastric glands due to uncertainty of the diagnosis. The aim of this study was to investigate clinical implications and risk factors for predicting malignancy in atypical gastric glands during forceps biopsy.
METHODS
We retrospectively reviewed medical records of 252 patients with a diagnosis of atypical gastric gland during forceps biopsy. Predictors of malignancy were analyzed using initial endoscopic findings and clinical data.
RESULTS
The final diagnosis for 252 consecutive patients was gastric cancer in 189 (75%), adenoma in 26 (10.3%), and gastritis in 37 (14.7%). In the multivariate analysis, lesion sizes of more than 10 mm (odds ratio [OR], 3.021; 95% confidence interval [CI], 1.480 to 6.165; p=0.002), depressed morphology (OR, 3.181; 95% CI, 1.579 to 6.406, p=0.001), and surface nodularity (OR, 3.432; 95% CI, 1.667 to 7.064, p=0.001) were significant risk factors for malignancy.
CONCLUSIONS
Further evaluation and treatment should be considered for atypical gastric gland during forceps biopsy if there is a large-sized (>10 mm) lesion, depressed morphology, or surface nodularity.

Keyword

Atypical gland; Forcep biopsy; Stomach neoplasms; Adenoma; Gastritis

MeSH Terms

Adenoma
Biopsy*
Diagnosis
Endoscopy
Gastric Mucosa*
Gastritis
Humans
Medical Records
Multivariate Analysis
Retrospective Studies
Risk Factors*
Stomach Neoplasms
Surgical Instruments*
Uncertainty