Is Endoscopic Mucosal Resection a Sufficient Treatment for Low-Grade Gastric Epithelial Dysplasia?.
- Author:
Seul Young KIM
1
;
Jae Kue SUNG
;
Hee Seok MOON
;
Kyu Seop KIM
;
Il Soon JUNG
;
Beom Yong YOON
;
Beom Hee KIM
;
Kwang Hun KO
;
Hyun Yong JEONG
Author Information
1. Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. jeonghy@cnuh.co.kr
- Publication Type:Original Article
- Keywords:
Adenoma;
Low-grade dysplasia;
Endoscopic mucosal resection;
Endoscopic submucosal dissection
- MeSH:
Adenoma;
Endoscopy, Digestive System;
Humans;
Incidence;
Prevalence;
Recurrence;
Risk Factors;
Stomach Neoplasms
- From:Gut and Liver
2012;6(4):446-451
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The rate of diagnosis of gastric adenoma has increased because esophagogastroduodenoscopy is being performed at an increasingly greater frequency. However, there are no treatment guidelines for low-grade dysplasia (LGD). To determine the appropriate treatment for LGD, we evaluated the risk factors associated with the categorical upgrade from LGD to high grade dysplasia (HGD)/early gastric cancer (EGC) and the risk factors for recurrence after endoscopic treatment. METHODS: We compared the complication rates, recurrence rates, and remnant lesions in 196 and 56 patients treated with endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR), respectively, by histologically confi rming low-grade gastric epithelial dysplasia. RESULTS: The en bloc resection rate was significantly lower in the EMR group (31.1%) compared with the ESD group (75.0%) (p<0.001). However, no significant difference was observed in the prevalence of remnant lesions or recurrence rate (p=0.911) of gastric adenoma. The progression of LGD to HGD or EGC caused an increase in the incidence of tumor lesions >1 cm with surface redness and depressions. CONCLUSIONS: For the treatment of LGD, EMR resulted in a higher incidence of uncertain resection margins and a lower en bloc resection rate than ESD. However, there was no signifi cant difference in recurrence rate.
