Risk factors for under-diagnosis of esophageal intra-epithelial neoplasia with endoscopic forceps biopsy in comparison with endoscopic submucosal dissection
10.3760/cma.j.issn.1007-5232.2016.06.003
- VernacularTitle:活检病理提示食管低级别上皮内瘤变发生内镜黏膜下剥离术后病理升级的危险因素分析
- Author:
Song ZHANG
;
Qibin HE
;
Chunyan PENG
;
Lei WANG
;
Tingsheng LING
;
Yiyang ZHANG
;
Ying LYU
;
Xiaoqi ZHANG
;
Xiaoping ZOU
- Publication Type:Journal Article
- Keywords:
Esophageal low-grade intra-epithelial neoplasia;
Endoscopic submucosal dissection;
Pathological upgrading;
Risk factor
- From:
Chinese Journal of Digestive Endoscopy
2016;33(6):357-361
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the risk factors for pathological upgrading after diagnosis of esophageal low?grade intra?epithelial neoplasia with ESD preoperative biopsy. Methods The endoscopic and pathological data of 85 lesions with ESD preoperative biopsy were analyzed, and grouped based on pathological upgrading after ESD. The risk factors for pathological upgrading after ESD was studied through single and multiple factor analysis. Results Pathological upgrading occurred in 45(52?94%) lesions after ESD, among whom 38 lesions developed up to high?grade intra?epithelial neoplasia and 7 lesions developed to esophageal early cancer. NBI?ME was performed on 37 patients and the accuracy of detecting the pathological invasion was 83?8%(31/37).Multi?factor analysis showed that reddish surface(OR=9?478, 95%CI:2?775?32?368, P = 0?000 3 ) and nodular lesion ( OR = 15?628, 95%CI:1?475?165?617, P =0?022 5) were independent factors for pathological upgrading after ESD. Conclusion Pathological upgrading of low?grade intra?epithelial neoplasia was common, especially esophageal mucosa with red surface and nodular lesion.Biopsy combined with NBI?ME is of significant importance to improve diagnostic accuracy.
