Turkish Journal of Gastroenterology
Original Article

Evaluation of endoscopic findings for discriminating between early carcinomas and low-grade adenomas in superficial elevated gastric lesions


Division of Gastroenterology, Yokohama City University Hospital, Yokohama, Japan


Office of Postgraduate Medical Education, Yokohama City University Hospital, Yokohama, Japan


Department of Pathology, Yokohama City University Graduate School of Medicine, Yokohama, Japan

Turk J Gastroenterol 2016; 27: 108-114
DOI: 10.5152/tjg.2015.150359
Read: 1772 Downloads: 771 Published: 25 July 2019


Background/Aims: This study aimed to determine the useful endoscopic findings in a differential diagnosis between early carcinomas (EC) and low-grade adenomas (LGA) in superficial elevated gastric epithelial neoplasia during conventional endoscopy with white-light imaging (C-WLI).


Materials and Methods: We investigated 270 consecutive cases of superficial elevated gastric epithelial neoplasias, which were removed by endoscopic submucosal dissection. The pathological diagnostic criteria were based on the revised Vienna classification: category 4 (mucosal high-grade neoplasia) or 5 (submucosal invasion by carcinoma) lesions were diagnosed as EC, while category 3 (mucosal low-grade neoplasia) lesions were diagnosed as LGA. The association between the postoperative pathological diagnoses (EC or LGA) and the following endoscopic findings: localized site, lesion size, color (reddish or whitish), shape (smooth, petal, or irregular), and presences of depression, erosion, ulceration, or nodularity on the surface, were evaluated.


Results: Of 270 epithelial neoplasias, 222 (58 LGA and 164 EC) were retrospectively evaluated. Multiple logistic regression analysis revealed that the lesion size [odds ratio (OR), 1.216; p<0.001) and reddish color (OR, 5.274; p<0.001) were independent findings for EC. 


Conclusion: The lesion size and reddish color were useful optical findings for discriminating between EC and LGA. 

EISSN 2148-5607