• Medicine · Jun 2024

    Observational Study

    The long-term outcome and risk factors of histologic discrepancy between forceps biopsies and endoscopic resections in early gastric cancer: An observational study.

    • Min-Kyung Yeo, Jae Ho Park, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong, and Ju Seok Kim.
    • Department of Pathology, Chungnam National University College of Medicine, Daejeon, Korea.
    • Medicine (Baltimore). 2024 Jun 7; 103 (23): e38451e38451.

    AbstractAlthough endoscopic forceps biopsy is the gold standard for early gastric cancer (EGC) diagnosis, the method can cause endoscopic resection of specimens and histological discrepancies. This study aims to examine the risk factors for histological discrepancies in EGC and long-term clinical outcomes. This retrospective study included patients diagnosed with differentiated-type EGC using forceps biopsy. Patients without histological discrepancies and with undifferentiated types in endoscopic resection histology were categorized into the concordant and discordant groups, respectively. Clinical characteristics and long-term outcomes related to histological discrepancies were analyzed. A total of 957 lesions from 936 patients were enrolled. An overall discrepancy rate of 8.7% was confirmed, with an undifferentiated-type discrepancy of 5.5%. The discordant group showed a higher tendency for lesions to be located in the upper third region, to have whitish discoloration, and to undergo a greater number of biopsies compared with the concordant group. Multivariate analysis confirmed that lesion location in the upper third region (odds ratio [OR]: 2.125; 95% confidence interval [CI]: 1.032-5.277; P = .041) and whitish surface discoloration (OR: 13.615; 95% CI: 6.028-28.728; P = .001) were significantly correlated with histologic discrepancy. Compared with the concordant group, the discordant group had a lower curative resection rate, but no differences were observed in complications, local recurrence, or survival rates. Upper third location and whitish discoloration were risk factors for the histologic discrepancy between differentiated and undifferentiated types in patients with EGC. For curative resections performed in patients with EGC and histologic discrepancies and without additional treatment, careful follow-up is possible.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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