Flat gastric polyps: Results of forceps biopsy, endoscopic mucosal resection, and long-term follow-up

Abstract

Forceps biopsy is not sufficiently reliable for the identification of gastric polyps. These lesions should be fully resected by EMR for a final diagnosis and (depending on the lesion size and type) possibly definitive treatment.

Risk factors in malignant transformation of gastric epithelial neoplasia categorized by the revised Vienna classification: endoscopic, pathological, and immunophenotypic features

“…However, this classifi cation is not perfect and it requires the consideration of additional information, including endoscopic fi ndings, pathology, and immunological feature, as well as molecular markers. In addition, the frequency of discrepant diagnoses between biopsy specimens and the corresponding resected specimens of the same lesions has ranged from 20% to 40% in previous reports [21][22][23]. In the clinical setting, many physicians have diffi culty with decisions on their therapeutic plan because of uncertainty with regard to the interpretation of biopsy reports.…”

Treatment strategy for gastric non-invasive intraepithelial neoplasia diagnosed by endoscopic biopsy

“…EMR with a snare allows for a more accurate histopathological diagnosis than forceps biopsy because the lesion can be resected as a large piece. Previous prospective studies indicate that EMR provides higher diagnostic accuracy than forceps biopsy and the histopathology and complications are within expected norms; based on these studies, EMR is recommended by several reports for diagnosis [36][37][38][39] . EMR is limited, however, in that it sometimes results in a multiple piecemeal resection.…”

Predictive factors suggesting an underestimation of gastric lesions initially diagnosed as adenomas by forceps biopsy

“…However, some of the adenomatous lesions may be misdiagnosed before treatment. The discrepancy rates between forceps biopsy samples and post-resected specimens ranged from 20% to 40% in previous reports (20)(21)(22)(23). Discrepancies occur because the amount of tissue obtained by forceps biopsy is too small to represent the histology of the entire tumor le- sion.…”