PREDICTIVE MODEL FOR NON-NEOPLASTIC PATHOLOGY RESULTS AFTER ENDOSCOPIC RESECTION OF EARLY GASTRIC CANCER

Aims:

Rate of non-neoplastic pathology (NNP) results after endoscopic resection (ER) of gastric epithelial neoplasia (GEN) has been reported as 3˜7%. However, pretreatment characteristics for NNP results have not been identified to date. The aim of this study was to develop a predictive model for NNP results after ER.

Methods:

Among 817 patients who underwent ER for GEN, factors associated with NNP results were identified by univariate and multivariate analyses. Weighted points considering β coefficient were allocated to each variables which were significant after multivariate analysis. Predictive score was calculated by total points. Area under receiver operating curve (AUROC) of the predictive score was calculated.

Results:

The rate of NNP results was 8.8%. After multivariate analysis, poor demarcation from the background, no ulcer, flat appearance, and low grade dysplasia were significant factors for NNP results. One point was allocated in no ulcer, flat appearance, and low grade dysplasia. Two points were allocated in poor demarcation from the background. Predictive score ranged from 0 to 5 point. Patients were categorized as low risk group (point 0,1,2), or high risk group (point 3,4,5) for NNP results. AUROC was 0.82 (p< 0.01, 95% CI 0.77 – 0.88). With cut-off points of 2.5, the sensitivity and specificity of predictive score was 0.72 and 0.84, respectively.

Conclusions:

We developed a predictive model for NNP results after ER. Endoscopic rebiopsy or re-evaluation by pathologists is strongly recommended in high risk group.