E-ISSN 2148-5607
Original Article
Evaluation of endoscopic findings for discriminating between early carcinomas and low-grade adenomas in superficial elevated gastric lesions
1 Division of Gastroenterology, Yokohama City University Hospital, Yokohama, Japan  
2 Office of Postgraduate Medical Education, Yokohama City University Hospital, Yokohama, Japan  
3 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
Key Words: Gastric adenoma, early gastric carcinoma, superficial elevated gastric epithelial neoplasias, conventional endoscopy
Abstract

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. 

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