Endoscopic or Follow-up Treatment for Gastric Indeterminate Tumors Is the Preferred Method of Management

BACKGROUND: Endoscopic forceps biopsy (EFB) lacks precision in diagnosing indeterminate tumors. When the presence of early gastric cancer (EGC) is macroscopically suspected, but biopsy pathology fails to give a diagnosis of neoplasia, it causes problems in clinical management. The purpose of this st...

Descripción completa

Detalles Bibliográficos
Autores principales: Xiao, Jun, Yu, Chao, Chen, Jing, Sun, Renhu, Jin, Hailin, Liu, Chunyang, Wang, Yaohui, Sun, Zhiguang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326109/
https://www.ncbi.nlm.nih.gov/pubmed/35912235
http://dx.doi.org/10.3389/fonc.2022.947810
_version_ 1784757204852670464
author Xiao, Jun
Yu, Chao
Chen, Jing
Sun, Renhu
Jin, Hailin
Liu, Chunyang
Wang, Yaohui
Sun, Zhiguang
author_facet Xiao, Jun
Yu, Chao
Chen, Jing
Sun, Renhu
Jin, Hailin
Liu, Chunyang
Wang, Yaohui
Sun, Zhiguang
author_sort Xiao, Jun
collection PubMed
description BACKGROUND: Endoscopic forceps biopsy (EFB) lacks precision in diagnosing indeterminate tumors. When the presence of early gastric cancer (EGC) is macroscopically suspected, but biopsy pathology fails to give a diagnosis of neoplasia, it causes problems in clinical management. The purpose of this study was to discuss the outcome of gastric indeterminate tumors and the clinical factors associated with predicting EGC. METHODS: The medical records of 209 patients diagnosed with gastric indeterminate neoplasia by biopsy forceps were retrospectively studied. Initial endoscopic findings were analyzed and predictors of EGC were evaluated. RESULTS: The final pathological diagnosis in 209 patients included adenocarcinoma (n = 7), high-grade intraepithelial neoplasia (n = 11), low-grade intraepithelial neoplasia (n = 21), and non-neoplastic lesion (n = 170). Multivariate analysis showed that older age (OR = 1.78; 95% CI = 1.17–2.71; p = 0.008), patients undergoing narrow band imaging (NBI) (OR = 3.40; 95% CI = 1.37–8.43; p = 0.008), and surface erosion (OR = 3.53; 95% CI = 1.41–8.84; p = 0.007) were associated with the upgraded group, and were significantly associated with risk. Univariate logistic regression analysis showed that among patients with NBI, the presence of demarcation line (DL) (OR = 24.00; 95% CI = 4.99–115.36; p < 0.0001), microvascular (MV) pattern irregularity (OR = 9.129; 95% CI = 2.36–35.34; p = 0.001), and the presence of white opaque substance (WOS) (OR = 10.77; 95% CI = 1.14–101.72; p = 0.038) were significant risk factors. CONCLUSIONS: For gastric indeterminate tumors, older patient age, lesion surface with erosion, clear DL visible under NBI observation, presence of WOS, and irregular MV pattern are suggestive of the high possibility of neoplasia and need to be focused on and may benefit more from endoscopic resection treatment as opposed to simple endoscopic follow-up.
format Online
Article
Text
id pubmed-9326109
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-93261092022-07-28 Endoscopic or Follow-up Treatment for Gastric Indeterminate Tumors Is the Preferred Method of Management Xiao, Jun Yu, Chao Chen, Jing Sun, Renhu Jin, Hailin Liu, Chunyang Wang, Yaohui Sun, Zhiguang Front Oncol Oncology BACKGROUND: Endoscopic forceps biopsy (EFB) lacks precision in diagnosing indeterminate tumors. When the presence of early gastric cancer (EGC) is macroscopically suspected, but biopsy pathology fails to give a diagnosis of neoplasia, it causes problems in clinical management. The purpose of this study was to discuss the outcome of gastric indeterminate tumors and the clinical factors associated with predicting EGC. METHODS: The medical records of 209 patients diagnosed with gastric indeterminate neoplasia by biopsy forceps were retrospectively studied. Initial endoscopic findings were analyzed and predictors of EGC were evaluated. RESULTS: The final pathological diagnosis in 209 patients included adenocarcinoma (n = 7), high-grade intraepithelial neoplasia (n = 11), low-grade intraepithelial neoplasia (n = 21), and non-neoplastic lesion (n = 170). Multivariate analysis showed that older age (OR = 1.78; 95% CI = 1.17–2.71; p = 0.008), patients undergoing narrow band imaging (NBI) (OR = 3.40; 95% CI = 1.37–8.43; p = 0.008), and surface erosion (OR = 3.53; 95% CI = 1.41–8.84; p = 0.007) were associated with the upgraded group, and were significantly associated with risk. Univariate logistic regression analysis showed that among patients with NBI, the presence of demarcation line (DL) (OR = 24.00; 95% CI = 4.99–115.36; p < 0.0001), microvascular (MV) pattern irregularity (OR = 9.129; 95% CI = 2.36–35.34; p = 0.001), and the presence of white opaque substance (WOS) (OR = 10.77; 95% CI = 1.14–101.72; p = 0.038) were significant risk factors. CONCLUSIONS: For gastric indeterminate tumors, older patient age, lesion surface with erosion, clear DL visible under NBI observation, presence of WOS, and irregular MV pattern are suggestive of the high possibility of neoplasia and need to be focused on and may benefit more from endoscopic resection treatment as opposed to simple endoscopic follow-up. Frontiers Media S.A. 2022-07-13 /pmc/articles/PMC9326109/ /pubmed/35912235 http://dx.doi.org/10.3389/fonc.2022.947810 Text en Copyright © 2022 Xiao, Yu, Chen, Sun, Jin, Liu, Wang and Sun https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Xiao, Jun
Yu, Chao
Chen, Jing
Sun, Renhu
Jin, Hailin
Liu, Chunyang
Wang, Yaohui
Sun, Zhiguang
Endoscopic or Follow-up Treatment for Gastric Indeterminate Tumors Is the Preferred Method of Management
title Endoscopic or Follow-up Treatment for Gastric Indeterminate Tumors Is the Preferred Method of Management
title_full Endoscopic or Follow-up Treatment for Gastric Indeterminate Tumors Is the Preferred Method of Management
title_fullStr Endoscopic or Follow-up Treatment for Gastric Indeterminate Tumors Is the Preferred Method of Management
title_full_unstemmed Endoscopic or Follow-up Treatment for Gastric Indeterminate Tumors Is the Preferred Method of Management
title_short Endoscopic or Follow-up Treatment for Gastric Indeterminate Tumors Is the Preferred Method of Management
title_sort endoscopic or follow-up treatment for gastric indeterminate tumors is the preferred method of management
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9326109/
https://www.ncbi.nlm.nih.gov/pubmed/35912235
http://dx.doi.org/10.3389/fonc.2022.947810
work_keys_str_mv AT xiaojun endoscopicorfollowuptreatmentforgastricindeterminatetumorsisthepreferredmethodofmanagement
AT yuchao endoscopicorfollowuptreatmentforgastricindeterminatetumorsisthepreferredmethodofmanagement
AT chenjing endoscopicorfollowuptreatmentforgastricindeterminatetumorsisthepreferredmethodofmanagement
AT sunrenhu endoscopicorfollowuptreatmentforgastricindeterminatetumorsisthepreferredmethodofmanagement
AT jinhailin endoscopicorfollowuptreatmentforgastricindeterminatetumorsisthepreferredmethodofmanagement
AT liuchunyang endoscopicorfollowuptreatmentforgastricindeterminatetumorsisthepreferredmethodofmanagement
AT wangyaohui endoscopicorfollowuptreatmentforgastricindeterminatetumorsisthepreferredmethodofmanagement
AT sunzhiguang endoscopicorfollowuptreatmentforgastricindeterminatetumorsisthepreferredmethodofmanagement