Endoscopy 2018; 50(04): S145-S146
DOI: 10.1055/s-0038-1637469
ESGE Days 2018 ePosters
Georg Thieme Verlag KG Stuttgart · New York

ACCURACY OF FORCEPS BIOPSY OF GASTRIC EPITHELIAL NEOPLASIA BEFORE ENDOSCOPIC SUBMUCOSAL DISSECTION

M Gomez
1   Complejo Hospitalario de Navarra, Endoscopy Department, Pamplona, Spain
,
M Rullan
2   Complejo Hospitalario de Navarra, Pamplona, Spain
,
A Elosua
2   Complejo Hospitalario de Navarra, Pamplona, Spain
,
D Oyon
2   Complejo Hospitalario de Navarra, Pamplona, Spain
,
S Lopez
2   Complejo Hospitalario de Navarra, Pamplona, Spain
,
J Carrascosa
2   Complejo Hospitalario de Navarra, Pamplona, Spain
,
JF Juanmartiñena
2   Complejo Hospitalario de Navarra, Pamplona, Spain
,
L Uribarri
2   Complejo Hospitalario de Navarra, Pamplona, Spain
,
E Albeniz
2   Complejo Hospitalario de Navarra, Pamplona, Spain
,
JJ Vila
2   Complejo Hospitalario de Navarra, Pamplona, Spain
› Author Affiliations
Further Information

Publication History

Publication Date:
27 March 2018 (online)

 

Aims:

Previous studies from eastern countries found that approximately 25% to 35% of the histological diagnoses based on forceps biopsies for gastric dysplastic lesions change following endoscopic resection. The aim of this study was to compare the diagnostic accuracy between conventional forceps biopsy and endoscopic submucosal dissection (ESD) in a western country.

Methods:

Retrospective and prospective observational study of all the gastric lesions resected by ESD in our centre between June 2012 and June 2017. The study was approved by the Ethics Commission of our institution.

Results:

We performed 33 gastric ESD. The median patient age was 69.7 years and the 51.5% were female. Median largest diameter of the lesions was 34,6 mm. The morphology of the lesions was: 51.5% lIa-IIc, 12.1% IIb-IIc, 21.2% Is, 9.1% IIa, 3% IIb y 3% IIa+b. The previous histological diagnosis was: 57.6% high grade dysplasia (HGD), 18.2% low grade dysplasia (LGD) and 24.4% non-dysplastic lesions. The histological diagnosis after ESD was: 24.2% adenocarcinoma with submucosal invasion, 45.5% HGD, 3% LGD, 27.3% non-dysplastic lesions. The overall histological concordance rate was 53.4%. Kappa coefficient was 0.403. 36.8% of the HGD were finally ADC with submucosal invasion and 66.6% of the LGD were HGD. The concordance rate according to location was: gastric antrum 70.5%, gastric angle 33.3%, gastric body 20%. The concordance rate according to morphology was: Is 100%, IIa 100%, IIb 100%, IIa-IIb 100%, IIa-IIc 35.3% and IIb-IIc 25%.

Conclusions:

The concordance pre-post ESD was moderated. Most of the LGD were finally HGD and more than one third of the HGD had submucosal invasion. According to our analysis, the concordance rate is lower in lesions with depressed morphology and lesions located in body or gastric angle. Biopsy-based diagnosis can be insufficient for gastric lesions and the ESD can be considered not only as treatment but also as a diagnostic modality.