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Predicting pre‐ and post‐resectional histologic discrepancies in gastric low‐grade dysplasia: A comparison of white‐light and magnifying endoscopy
Author(s) -
Hwang Jin Won,
Bae Young Seok,
Kang Mi Seon,
Kim Ji Hyun,
Jee Sam Ryong,
Lee Sang Heon,
An Min Sung,
Kim Kwang Hee,
Bae Ki Beom,
Kim Bomi,
Seol Sang Young
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13195
Subject(s) - medicine , endoscopy , white light , dysplasia , white (mutation) , nuclear medicine , radiology , pathology , optics , biochemistry , chemistry , physics , gene
Abstract Background and Aim The aim of this study was to evaluate the validity of the parameters of conventional white‐light endoscopy and magnifying endoscopy with narrow‐band imaging (MENBI) for the prediction of discrepancies between pre‐ and post‐resectional histology in cases of gastric adenoma with low‐grade dysplasia (LGD) that were diagnosed based on endoscopically biopsied specimens. Methods The medical records of 266 lesions with gastric LGD that were diagnosed by endoscopic forceps biopsies were retrospectively reviewed. The Vienna classification was used for histologic diagnosis. These patients all underwent MENBI examinations followed by analyses of the incidence of histologic discrepancies and histologic heterogeneity. The relationship between white‐light endoscopic/MENBI parameters and the presence of histologic discrepancies was also analyzed. Results Discrepancies between the pre‐ and post‐resectional histologies were found in 74 cases (27.9%). Among those cases, the histology was upgraded in 71 cases, whereas the histology was downgraded in three cases. The presence of erythema and positive MENBI findings were independent factors for the prediction of upgraded histologic discrepancies ( P ‐values = 0.008, < 0.001, respectively). A positive MENBI finding yielded the highest predictive value, with a multivariate adjusted odds ratio of 42.46. Histologic heterogeneity in post‐resectional specimens was found in 40.8% of cases with upgraded histologic discrepancies. Conclusions MENBI can provide more accurate information than white‐light endoscopy for the prediction of pre‐ and post‐resectional histologic discrepancies in biopsy‐proven gastric LGD. Endoscopic resection is strongly recommended in cases with surface erythema on conventional white‐light endoscopy or positive MENBI, irrespective of the lesion size.