Negative Biopsy after Referral for Biopsy-Proven Gastric Cancer
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: Repeat endoscopy with biopsy is often performed in patients with previously diagnosed gastric cancer to determine further treatment plans. However, biopsy results may differ from the original pathologic report. We reviewed patients who had a negative biopsy after referral for gastric cancer. Methods: A total of 116 patients with negative biopsy results after referral for biopsy-proven gastric cancer were enrolled. Outside pathology slides were reviewed. Images of the first and second endoscopic examinations were reviewed. We reviewed the clinical history from referral to the final treatment. Results: Eighty-eight patients (76%) arrived with information about the lesion from the referring physician. Among 96 patients with available outside slides, the rate of interobserver variation was 24%. Endoscopy was repeated at our institution; 85 patients (73%) were found to have definite lesions, whereas 31 patients (27%) had indeterminate lesions. In the group with definite lesions, 71% of the lesions were depressed in shape. The most common cause of a negative biopsy was mistargeting. In the group with indeterminate lesions, 94% had insufficient information. All patients with adequate follow-up were successfully treated based on the findings in the follow-up endoscopy. Conclusions: A negative biopsy after referral for biopsy-proven gastric cancer is mainly caused by mistargeting and insufficient information during the referral.
Abstract
Background/Aims: Repeat endoscopy with biopsy is often performed in patients with previously diagnosed gastric cancer to determine further treatment plans. However, biopsy results may differ from the original pathologic report. We reviewed patients who had a negative biopsy after referral for gastric cancer. Methods: A total of 116 patients with negative biopsy results after referral for biopsy-proven gastric cancer were enrolled. Outside pathology slides were reviewed. Images of the first and second endoscopic examinations were reviewed. We reviewed the clinical history from referral to the final treatment. Results: Eighty-eight patients (76%) arrived with information about the lesion from the referring physician. Among 96 patients with available outside slides, the rate of interobserver variation was 24%. Endoscopy was repeated at our institution; 85 patients (73%) were found to have definite lesions, whereas 31 patients (27%) had indeterminate lesions. In the group with definite lesions, 71% of the lesions were depressed in shape. The most common cause of a negative biopsy was mistargeting. In the group with indeterminate lesions, 94% had insufficient information. All patients with adequate follow-up were successfully treated based on the findings in the follow-up endoscopy. Conclusions: A negative biopsy after referral for biopsy-proven gastric cancer is mainly caused by mistargeting and insufficient information during the referral.
참고문헌 (14)
- Kyu-Won Jung, "Prediction of Cancer Incidence and Mortality in Korea, 2012", Cancer Research and Treatment, 44(1), pp.15~31 (2012), 대한암학회
- Kim Y, "Overview of the National Cancer screening programme and the cancer screening status in Korea", Asian Pac J Cancer Prev, 12, pp.725~730 (2011)
- Hatfield AR, "Importance of the site of endoscopic gastric biopsy in ulcerating lesions of the stomach", Gut, 16, pp.884~886 (1975)
- Misumi A, "Evaluation of fibergastroscopic biopsy in the diagnosis of gastric cancer: a study of 339 cases", Gastroenterol Jpn, 13, pp.255~263 (1978)
- Faigel DO, "Tissue sampling and analysis", Gastrointest Endosc, 57, pp.811~816 (2003)
- Graham DY, "Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma", Gastroenterology, 82, pp.228~231 (1982)
- Dixon MF, "Classification and grading of gastritis. The updated Sydney System. International Workshop on the Histopathology of Gastritis", Am J Surg Pathol, 20, pp.1161~1181 (1996)
- de Vries AC, "Biopsy strategies for endoscopic surveillance of pre-malignant gastric lesions", Helicobacter, 15, pp.259~264 (2010)
- Wang TD, "Optical biopsy: a new frontier in endoscopic detection and diagnosis", Clin Gastroenterol Hepatol, 2, pp.744~753 (2004)
- Choo MC, "A web-based referral system for neurosurgery: a solution to our problems?", Br J Neurosurg, 25, pp.384~387 (2011)
- Bhabra G, "An experimental comparison of handover methods", Ann R Coll Surg Engl, 89, pp.298~300 (2007)
- Kim JM, "Diagnosis of gastric epithelial neoplasia: dilemma for Korean pathologists", World J Gastroenterol, 17, pp.2602~2610 (2011)
- Ryoji Kushima, "Interobserver Variation in the Diagnosis of Gastric Epithelial Dysplasia and Carcinoma between Two Pathologists in Japan and Korea", Journal of Gastric Cancer, 11(3), pp.141~145 (2011), 대한위암학회
- Vieth M, "Pseudoneoplastic regeneration of the stomach: histopathology and differential diagnosis", Pathologe, 31, pp.171~176 (2010)