The Korean Journal of Internal Medicine

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Original Article
Korean J Med. 2006;71(6):600-608.
원저:위 점막 병변의 겸자 생검과 점막절제술 후의 조직 진단의 비교
김지연, , , , , , , , ,
Histological comparison of endoscopic forceps biopsy with endoscopic mucosal resection in the gastric lesions
Jee Yeon Kim, See Won Lee, Lee Chun Park, Jung Kwang Shin, Nam Young Park, Won Moon, Kyu Jong Kim, Moo In Park, Seun Ja Park, Hee Kyung Chang
고려대학교 의과대학 내과학교실


Abstract
Background : The correct histological diagnosis of a gastric adenoma is important, because an adenoma has been reported to be a precancerous lesion and is associated with focal gastric carcinoma. However, there is some discrepancy between the histology of a forceps biopsy and that of the endoscopic mucosal resection. This study compared the histological findings of a gastric mucosal lesion in the specimens of a forceps biopsy and an endoscopic mucosal resection.
Methods
: 88 cases of gastric mucosal lesions, which had been removed by the endoscopic mucosal resection, were reviewed retrospectively. All the patients had undergone a forceps biopsy before the endoscopic mucosal resection. The histological findings of the specimens by a forceps biopsy were compared with those by resection.
Results
: The histological findings were accordant at 52 of the 88 cases (59.1%). Among the 71 cases with adenoma or gastritis in the biopsied specimens, 13 cases (18.3%) were finally diagnosed with gastric cancer in the resected specimens. Among all the gastritis and adenomas determined by the forceps biopsy, the high-risk groups for adenocarcinomas were characterized by the following endoscopic findings: red-colored and depressed lesions.
Conclusions
: Biopsy specimens may not be representative of the entire lesion. Therefore, an endoscopic resection of a gastric mucosal lesion is needed for making an accurate histological diagnosis and treatment if adenomas such as red-colored or depressed lesions are suspected. (Korean J Med 71:600-608, 2006) Key Words : Gastric mucosal disease, Forceps biopsy, Endoscopic mucosal resection, Histolgy

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