Routine gastric biopsies: Should we be doing more?

Huang, Robert J.; Hwang, Joo Ha

doi:10.1016/j.gie.2019.02.010

Cited by 4 publications

(4 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…26 However, increased diagnostic sensitivity through more biopsies comes at the cost of more negative biopsy results and high costs. 27 AI with high accuracy can reduce unnecessary biopsies and pathological examinations. 28 We believe that AI can potentially reduce unnecessary biopsies, rather than replace biopsies and pathological examinations.…”

Section: Discussionmentioning

confidence: 99%

“…Whitish gastric lesions under WLE are not an indication for magnifying narrow‐band imaging (M‐NBI) but for taking biopsies, as none of the cancerous features appear under M‐NBI 26 . However, increased diagnostic sensitivity through more biopsies comes at the cost of more negative biopsy results and high costs 27 . AI with high accuracy can reduce unnecessary biopsies and pathological examinations 28 .…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of incorporating domain knowledge with deep learning in identifying benign and malignant gastric whitish lesions: A retrospective study

Zeng,

Yang,

Dong

et al. 2024

J of Gastro and Hepatol

View full text Add to dashboard Cite

Background and AimEarly whitish gastric neoplasms can be easily misdiagnosed; differential diagnosis of gastric whitish lesions remains a challenge. We aim to build a deep learning (DL) model to diagnose whitish gastric neoplasms and explore the effect of adding domain knowledge in model construction.MethodsWe collected 4558 images from two institutions to train and test models. We first developed two sole DL models (1 and 2) using supervised and semi‐supervised algorithms. Then we selected diagnosis‐related features through literature research and developed feature‐extraction models to determine features including boundary, surface, roundness, depression, and location. Then predictions of the five feature‐extraction models and sole DL model were combined and inputted into seven machine‐learning (ML) based fitting‐diagnosis models. The optimal model was selected as ENDOANGEL‐WD (whitish‐diagnosis) and compared with endoscopists.ResultsSole DL 2 had higher sensitivity (83.12% vs 68.67%, Bonferroni adjusted P = 0.024) than sole DL 1. Adding domain knowledge, the decision tree performed best among the seven ML models, achieving higher specificity than DL 1 (84.38% vs 72.27%, Bonferroni adjusted P < 0.05) and higher accuracy than DL 2 (80.47%, Bonferroni adjusted P < 0.001) and was selected as ENDOANGEL‐WD. ENDOANGEL‐WD showed better accuracy compared with 10 endoscopists (75.70%, P < 0.001).ConclusionsWe developed a novel system ENDOANGEL‐WD combining domain knowledge and traditional DL to detect gastric whitish neoplasms. Adding domain knowledge improved the performance of traditional DL, which provided a novel solution for establishing diagnostic models for other rare diseases potentially.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effect of incorporating domain knowledge with deep learning in identifying benign and malignant gastric whitish lesions: A retrospective study

Zeng,

Yang,

Dong

et al. 2024

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…Although some studies oppose routine biopsy, arguing that it has little effect on the treatment process and unnecessarily increases costs, there are studies advocating that biopsies should also be taken from normal-appearing mucosa to detect possible pathologic findings. [8][9][10][11][12] Furthermore, the rate of abnormal histopathologic findings detected in biopsies taken from endoscopically normal mucosa varies between different series. 7,13,14 We aimed to evaluate antral biopsies obtained during normal esophagogastroduodenoscopy and contribute to the existing literature.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there is no consensus on taking a biopsy from endoscopically normal mucosal areas during EGD. Although some studies oppose routine biopsy, arguing that it has little effect on the treatment process and unnecessarily increases costs, there are studies advocating that biopsies should also be taken from normal-appearing mucosa to detect possible pathologic findings 8–12 . Furthermore, the rate of abnormal histopathologic findings detected in biopsies taken from endoscopically normal mucosa varies between different series 7,13,14 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Antral Biopsies Obtained in Endoscopically Normal Esophagogastroduodenoscopy: A Retrospective Cohort Study

Dinçer,

Ömeroğlu,

Güven

et al. 2024

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

View full text Add to dashboard Cite

Background: The requirement for routine biopsy sampling in esophagogastroduodenoscopy (EGD) with normal endoscopic findings is a subject of debate. In this study, patients who had normal endoscopic findings in EGD and underwent biopsy sampling were retrospectively analyzed. Methods: This single-center retrospective cohort study included 671 patients who underwent EGD between 2021 and 2023 in the Sisli Hamidiye Etfal Training and Research Hospital Surgical Endoscopy Unit. All patients had normal endoscopic findings and a sampling biopsy was performed on all patients included. Patients were evaluated based on demographic and clinicopathologic findings. This study was registered to ClinicalTrials.gov (NCT06269380). Results: Two hundred sixty patients (38.7%) have abnormal histopathologic findings. Helicobacter pylori positivity was detected in 200 (29.8%) patients. Intestinal metaplasia (IM) was present in 80 of 260 patients (30.8%). The frequency of IM was higher in older age groups and cases with mild gastritis (P<0.001). The frequency and severity of gastritis were associated with increased H. pylori positivity and density (P<0.001). Conclusions: The biopsy sampling may contribute to the diagnosis and treatment process in cases where normal endoscopic findings are observed during EGD.

show abstract

Survival outcomes and rate of missed upper gastrointestinal cancers at routine endoscopy: a single centre retrospective cohort study

Gavrić

Hanžel

Žagar

et al. 2020

European Journal of Gastroenterology &Amp; Hepatology

View full text Add to dashboard Cite

Objectives Data on the long-term survival outcome of patients with missed upper gastrointestinal cancers (MUGC) is lacking. Retrospective studies have found no difference in 1- and 2-year survival among patients with missed gastric and oesophageal cancers; we thus aimed to assess 3-year survival of patients with MUGC at oesophagogastroduodenoscopy. Methods This was a retrospective cohort study conducted at a single tertiary endoscopy centre. All oesophagogastroduodenoscopies performed between January 2007 and December 2015 were included in the study. The endoscopy database was cross-matched with the Slovenian Cancer Registry database. Missed cancers were defined as those diagnosed within 36 months after a negative oesophagogastroduodenoscopy. Results During the study period, 29 617 oesophagogastroduodenoscopies were performed. In total, 422 upper gastrointestinal cancers were diagnosed and the rate of missed gastric cancers was 7.3% (95% CI, 4.9–10.6%) (26/354), and 4.4% (95% CI, 0.9–12.4%) for oesophageal cancers (3/68). Three-year survival of patients with MUGC was shorter than that of those with non-MUGC, being 12% (95% CI, 1–25%) vs. 31% (95% CI, 26–36%) (P = 0.043) for gastric and 0 vs. 9% (95% CI, 1–17%) (P = 0.121) for oesophageal cancer. Conclusion Missed gastric cancer during oesophagogastroduodenoscopy may be associated with shorter 3-year survival compared to patients whose gastric cancer was diagnosed at index oesophagogastroduodenoscopy.

show abstract

Routine gastric biopsies: Should we be doing more?

Cited by 4 publications

References 7 publications

The effect of incorporating domain knowledge with deep learning in identifying benign and malignant gastric whitish lesions: A retrospective study

The effect of incorporating domain knowledge with deep learning in identifying benign and malignant gastric whitish lesions: A retrospective study

Evaluation of Antral Biopsies Obtained in Endoscopically Normal Esophagogastroduodenoscopy: A Retrospective Cohort Study

Survival outcomes and rate of missed upper gastrointestinal cancers at routine endoscopy: a single centre retrospective cohort study

Contact Info

Product

Resources

About