The Histologic Discrepancy before and after Endoscopic Submucosal Dissection of Gastric Adenoma and Early Gastric Cancer

Background/Aims: We wanted to investigate of discrepancy rate between the histology of the endoscopic biopsy and that of the resected specimen obtained from the same lesion by endoscopic submucosal dissection (ESD). Methods: 69 gastric adenomas and 38 early gastric cancers (EGC) that were treated by ESD from July, 2004 to February, 2006 were reviewed to analyze the relation between the histologies of the endoscopic biopsy and the resected specimen. Results: The discrepancy rate between the histology of the endoscopic biopsy and the resected specimen was 40.6% for the gastric adenoma and 23.7% for the EGC. Among the 43 cases of low grade dysplasia, 6 cases (14%) were confirmed as gastric cancer after ESD. Conclusions: The histologic discrepancy between the endoscopic biopsy and resected specimen was 40.6% for the gastric adenoma and 23.7% for the EGC. Though the endoscopic biopsy may reveal low grade dysplasia, gastric adenoma should be removed by endoscopic mucosal resection because of the histological discrepancy between the endoscopic biopsy and the resected specimen. (Korean J Gastrointest Endosc 2007;34:125-131)