Incidence of gastric adenocarcinoma among lesions diagnosed as low-grade adenoma/dysplasia on endoscopic biopsy: A multicenter, prospective, observational study

Akira Maekawa, Motohiko Kato, Takeshi Nakamura, Masato Komori, Takuya Yamada, Katsumi Yamamoto, Hideharu Ogiyama, Masanori Nakahara, Naoki Kawai, Takamasa Yabuta, Akira Mukai, Yoshito Hayashi, Tsutomu Nishida, Hideki Iijima, Masahiko Tsujii, Eiichi Morii, Tetsuo Takehara

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6 Citations (Scopus)

Abstract

Background and Aim: Differentiation between gastric adenocarcinoma and low-grade adenoma/dysplasia (LGA) on endoscopic forceps biopsy is difficult. We aim to clarify the incidence of carcinoma in specimens, obtained by endoscopic resection (ER), from cases that had been diagnosed as LGA (Vienna category 3) on endoscopic biopsy. Methods: In this multicenter, prospective, observational study, patients with gastric adenoma (Vienna category 3 or 4.1) diagnosed on endoscopic forceps biopsy were enrolled. All the specimens were subjected to histopathological central review. Primary endpoint was the incidence of carcinoma (Vienna category 4.2 or over) among the biopsy-proven gastric LGA. Secondary endpoints were the histological findings of resected specimens, clinicopathological features of carcinoma, and short-term outcomes of all ER cases. Results: Ninety-five patients with 104 lesions diagnosed as gastric adenoma were enrolled. After central review of the biopsy specimens, 47 lesions were diagnosed as LGA and seven lesions (15%) as adenocarcinoma (95% confidence interval, 7.6–28%). Carcinoma was detected in lesions that had a minimum size of 6 mm; the incidence of carcinoma was higher in the larger lesions. There was a histological discrepancy between biopsy and ER material in more than 60% of the cases. Conclusions: A substantial proportion of biopsy-proven gastric LGA specimens were diagnosed as adenocarcinoma after ER. This indicated histological discrepancy between biopsy-proven gastric LGA and histology of the resected material.

Original languageEnglish
Pages (from-to)228-235
Number of pages8
JournalDigestive Endoscopy
Volume30
Issue number2
DOIs
Publication statusPublished - 2018 Mar 1
Externally publishedYes

Keywords

  • early diagnosis of cancer
  • endoscopic submucosal dissection
  • gastric cancer
  • gastric neoplasm
  • prospective study

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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    Maekawa, A., Kato, M., Nakamura, T., Komori, M., Yamada, T., Yamamoto, K., Ogiyama, H., Nakahara, M., Kawai, N., Yabuta, T., Mukai, A., Hayashi, Y., Nishida, T., Iijima, H., Tsujii, M., Morii, E., & Takehara, T. (2018). Incidence of gastric adenocarcinoma among lesions diagnosed as low-grade adenoma/dysplasia on endoscopic biopsy: A multicenter, prospective, observational study. Digestive Endoscopy, 30(2), 228-235. https://doi.org/10.1111/den.12980