Preoperative biopsy in the treatment of gastric mucosal lesions by endoscopic submucosal dissection
10.3760/cma.j.issn.1007-5232.2012.03.011
- VernacularTitle:术前活检在胃黏膜病变内镜黏膜下剥离术治疗中的价值分析
- Author:
You ZHANG
;
Enqiang LINGHU
;
Zhongsheng LU
;
Hong DU
;
Xiangdong WANG
;
Jiangyun MENG
;
Hongbin WANG
- Publication Type:Journal Article
- Keywords:
Intraepithelial neoplasia;
Early cancer;
Biopsy;
Endoscopic submucosal dissection;
Pathology
- From:
Chinese Journal of Digestive Endoscopy
2012;29(3):151-154
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo evaluate preoperative biopsy in the treatment of gastric mucosal lesions by endoscopic submucosal dissection (ESD).MethodsClinical data of 195 patients diagnosed as having gastric intraepithelial neoplasia (GIEN) or early cancer by preoperative biopsy were retrospectively analyzed.The discrepancy between endoscopic biopsies and pathological diagnosis after ESD were studied.ResultsThe overall consistency rate between preoperative biopsies and postoperative pathological diagnosis was 93.8％ (183/195) and complete consistency rate was 50.8％ (99/195).For low-grade and highgrade gastric intraepithelial neoplasia ( LGIEN),the complete consistency rates were 49.4％ (42/85)and 38.0％ (30/79),respectively,which were not different ( P ＞ 0.05 ).For early cancer it was 87.1％(27/31 ),which was significantly higher than those in the LGIEN group and HGIEN group ( P ＜ 0.05 ).Post-ESD diagnosis was more severe than biopsy in 66 patients (33.8％,66/195 ),including 36 LGIEN (42.4％,36/85) and 30 HGIEN (38.0％,30/79).Final pathological diagnosis was milder than biopsy in 18 patients (9.2％,18/195),i.e.14 HGIEN (17.7％,14/79) and 4 early cancer (12.9％,4/31).Gastritis was diagnosed in 12 patients (6.2％,12/195),i.e.7 LGIEN (8.2％,7/85) and 5 HGIEN (6.3％,5/79).ConclusionPreoperative biopsy is insufficient for accurate diagnosis of gastric mucosal lesions,but facilitates resection of gastric mucosal lesions by ESD.
