ArticleBMC gastroenterology2024
Risk factors for pathological upgrading and noncurative resection in patients with gastric mucosal lesions after endoscopic submucosal dissection.
Article in BMC gastroenterology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed.
- Impact of real-time artificial intelligence integration on detection of gastric lesions: an exploratory single-center before-and-after study using low-definition routine endoscopy.Clinical endoscopy · 2026Article
- Transrectal biplane ultrasound-guided transperineal biopsy for rectal and peri-rectal lesions: an 18-year retrospective analysis.Quantitative imaging in medicine and surgery · 2026Article
- Identification of potential hub biomarkers for gastric high-grade intraepithelial neoplasia early diagnosis: evidence from gene expression profiles and pathological characters.Translational cancer research · 2026Article
- Discrepancies between preoperative assessment and final pathological criteria in early gastric cancer.World journal of gastrointestinal oncology · 2026Article
- A multicenter retrospective study: risk factors and nomogram construction for pathological escalation of gastric low-grade intraepithelial neoplasia.Frontiers in medicine · 2026Article
- Endoscopic submucosal dissection for early gastric cancer and precancerous lesions enhances postoperative recovery and mitigates complication risks.World journal of gastrointestinal surgery · 2025Article
- Risk factors analysis for pathological upgrade after endoscopic submucosal dissection in patients with gastric intraepithelial neoplasia: a single-center retrospective study.Therapeutic advances in gastroenterology · 2025Article
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5 authors.
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Abstract
backgroundThe pathological results obtained from endoscopic forceps biopsy (EFB) do not always align with the findings of postoperative endoscopic submucosal dissection (ESD). Furthermore, as ESD becomes more widespread, the number of noncurative endoscopic cases increases; thus, an accurate preoperative diagnosis and an appropriate treatment method are crucial. The purpose of this study was to explore the risk factors for postoperative pathological upgrading and noncurative resection and to gather experience in clinical and pathological diagnosis.
methodsFrom March 2016 to November 2023, 292 ESD specimens were collected from 262 patients with gastric mucosal lesions. Clinicopathological information, the coincidence rate of pathological diagnosis between EFB and ESD specimens, and risk factors related to noncurative resection were analyzed retrospectively.
resultsThe overall upgraded pathological diagnosis rate between EFB and ESD was 26.4%. The independent predictors for the upgraded group included proximal stomach lesions, lesion size > 2 cm, surface ulceration, and surface nodules. Twenty of the 235 early gastric cancer (EGC) patients underwent noncurative ESD resection. Multivariate analysis showed that undifferentiated carcinoma and tumor infiltration into the submucosa were significantly associated with noncurative resection.
conclusionBiopsy cannot fully represent the lesions of gastric intraepithelial neoplasia (GIN). When a suspected epithelial dysplasia is suspected, a careful endoscopic examination should be conducted to evaluate the lesion site, size, and surface characteristics to ensure an accurate diagnosis. Noncurative endoscopic resection is associated with undifferentiated carcinoma and submucosal infiltration. Clinicians must be familiar with these predictive factors for noncurative resection and select the appropriate treatment for their patients.
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