Negative Histology after Endoscopic Resection: An Endoscopist’s Aspect

Endoscopic submucosal dissection (ESD) is accepted as the standard treatment for gastric epithelial dysplasia or early gastric cancer because it enables curative en bloc resection and complete histopathological assessment of the specimen. However, occasionally, a tumorous lesion may not be detected,...

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Main Authors: Sung Jae Shin, Min Jae Yang, Choong-Kyun Noh, Sun Gyo Lim, Kee Myung Lee, Kwang Jae Lee
Format: Article
Language:English
Published: Korean College of Helicobacter and Upper Gastrointestinal Research 2018-03-01
Series:The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Subjects:
Online Access:http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.1.17
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author Sung Jae Shin
Min Jae Yang
Choong-Kyun Noh
Sun Gyo Lim
Kee Myung Lee
Kwang Jae Lee
author_facet Sung Jae Shin
Min Jae Yang
Choong-Kyun Noh
Sun Gyo Lim
Kee Myung Lee
Kwang Jae Lee
author_sort Sung Jae Shin
collection DOAJ
description Endoscopic submucosal dissection (ESD) is accepted as the standard treatment for gastric epithelial dysplasia or early gastric cancer because it enables curative en bloc resection and complete histopathological assessment of the specimen. However, occasionally, a tumorous lesion may not be detected, and histopathological discrepancies can occur after ESD. Reportedly, the prevalence of negative histopathological results after endoscopic resection is 2.0∼4.4%. Negative histopathological results after endoscopic resection are commonly attributable to complete removal of the lesion via an endoscopic forceps biopsy (EFB) at the time of the initial diagnostic endoscopic examination, an initial histopathological overestimation of the EFB specimen, and incorrect localization of the original tumor with subsequent ESD performed at a wrong site. A small tumor size and surface area are known to be significant endoscopic predictors of negative histopathological results after ESD. Therefore, clinicians should be mindful of the fact that negative histopathological findings observed after endoscopic resection warrant a comprehensive review of all pre-ESD data and an adequate follow-up to determine the cause of these findings and to detect any possibility of local recurrence.
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issn 1738-3331
language English
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publisher Korean College of Helicobacter and Upper Gastrointestinal Research
record_format Article
series The Korean Journal of Helicobacter and Upper Gastrointestinal Research
spelling doaj-art-96355ba460904990874208a09d7e8b3f2025-08-20T03:57:04ZengKorean College of Helicobacter and Upper Gastrointestinal ResearchThe Korean Journal of Helicobacter and Upper Gastrointestinal Research1738-33312018-03-01181172010.7704/kjhugr.2018.18.1.17kjhugr.2018.18.1.17Negative Histology after Endoscopic Resection: An Endoscopist’s AspectSung Jae Shin0Min Jae Yang1Choong-Kyun Noh2Sun Gyo Lim3Kee Myung Lee4Kwang Jae Lee5Division of Gastroenterology, Department of Internal Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, KoreaDivision of Gastroenterology, Department of Internal Medicine, Ajou University Hospital, Ajou University School of Medicine, Suwon, KoreaEndoscopic submucosal dissection (ESD) is accepted as the standard treatment for gastric epithelial dysplasia or early gastric cancer because it enables curative en bloc resection and complete histopathological assessment of the specimen. However, occasionally, a tumorous lesion may not be detected, and histopathological discrepancies can occur after ESD. Reportedly, the prevalence of negative histopathological results after endoscopic resection is 2.0∼4.4%. Negative histopathological results after endoscopic resection are commonly attributable to complete removal of the lesion via an endoscopic forceps biopsy (EFB) at the time of the initial diagnostic endoscopic examination, an initial histopathological overestimation of the EFB specimen, and incorrect localization of the original tumor with subsequent ESD performed at a wrong site. A small tumor size and surface area are known to be significant endoscopic predictors of negative histopathological results after ESD. Therefore, clinicians should be mindful of the fact that negative histopathological findings observed after endoscopic resection warrant a comprehensive review of all pre-ESD data and an adequate follow-up to determine the cause of these findings and to detect any possibility of local recurrence.http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.1.17Endoscopic resectionHistologyStomach neoplasms
spellingShingle Sung Jae Shin
Min Jae Yang
Choong-Kyun Noh
Sun Gyo Lim
Kee Myung Lee
Kwang Jae Lee
Negative Histology after Endoscopic Resection: An Endoscopist’s Aspect
The Korean Journal of Helicobacter and Upper Gastrointestinal Research
Endoscopic resection
Histology
Stomach neoplasms
title Negative Histology after Endoscopic Resection: An Endoscopist’s Aspect
title_full Negative Histology after Endoscopic Resection: An Endoscopist’s Aspect
title_fullStr Negative Histology after Endoscopic Resection: An Endoscopist’s Aspect
title_full_unstemmed Negative Histology after Endoscopic Resection: An Endoscopist’s Aspect
title_short Negative Histology after Endoscopic Resection: An Endoscopist’s Aspect
title_sort negative histology after endoscopic resection an endoscopist s aspect
topic Endoscopic resection
Histology
Stomach neoplasms
url http://www.helicojournal.org/journal/view.html?doi=10.7704/kjhugr.2018.18.1.17
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