Tumor heterogeneity and carcinoma in resected specimens of gastric low-grade dysplasia: A retrospective single center study.
Lesions diagnosed as gastric low-grade dysplasia (LGD) may be pathologically upgraded to early gastric cancer (EGC) or high-grade dysplasia (HGD) after endoscopic resection (ER). In this study, we investigated the risk factors for pathological upgrades after ER and assessed the reason for these upgr...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0280735 |
| _version_ | 1828052283150041088 |
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| author | Ga-Yeong Shin Jun Young Park Sung Hak Lee Yu Kyung Cho Myung-Gyu Choi Jae Myung Park |
| author_facet | Ga-Yeong Shin Jun Young Park Sung Hak Lee Yu Kyung Cho Myung-Gyu Choi Jae Myung Park |
| author_sort | Ga-Yeong Shin |
| collection | DOAJ |
| description | Lesions diagnosed as gastric low-grade dysplasia (LGD) may be pathologically upgraded to early gastric cancer (EGC) or high-grade dysplasia (HGD) after endoscopic resection (ER). In this study, we investigated the risk factors for pathological upgrades after ER and assessed the reason for these upgrades by retrospectively analyzing ER data between January 1999 and December 2019. We enrolled patients with LGD confirmed by forceps biopsy; the patients were classified into pathologically concordant (LGD) and upgraded (HGD and EGC) groups according to the pathology of their resected specimen. To determine the risk factors for upgrade, we compared the endoscopic findings of the concordant and upgraded groups via 1:1 matched case-control design. To find the reasons for discordance, all upgraded cases were pathologically re-evaluated. Among 1,643 cases of LGD, pathological upgrades were observed in 423 (25.7%) resected specimens and EGC was found in 111 (6.7%) lesions. After matching the upgraded and concordant cases, lesion sizes exceeding 1.5 cm (odds ratio (OR): 1.8; 95% CI: 1.1-3.0), mucosal nodularity (OR: 10.8; 95% CI: 5.6-21.0), heterogeneous color (OR: 3.0; 95% CI: 1.7-5.3), presence of erosion (OR: 2.7; 95% CI: 1.8-5.3), and open-type gastric atrophy (OR: 2.9; 95% CI: 1.7-4.9) were noted to be significantly associated with upgraded pathology to EGC. Among the EGC cases, 99 (89.2%) were found to have pre-existing dysplasia. In conclusion, endoscopic evaluations should be performed because of possible pathological upgrades and co-existence of carcinomas in LGDs, especially when they exhibit surface nodularity, erosion, heterogeneous color, and large size. |
| first_indexed | 2024-04-10T19:51:13Z |
| format | Article |
| id | doaj.art-f6878f8c9218451b86eaafde8a8f22e7 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-10T19:51:13Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-f6878f8c9218451b86eaafde8a8f22e72023-01-28T05:31:00ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01181e028073510.1371/journal.pone.0280735Tumor heterogeneity and carcinoma in resected specimens of gastric low-grade dysplasia: A retrospective single center study.Ga-Yeong ShinJun Young ParkSung Hak LeeYu Kyung ChoMyung-Gyu ChoiJae Myung ParkLesions diagnosed as gastric low-grade dysplasia (LGD) may be pathologically upgraded to early gastric cancer (EGC) or high-grade dysplasia (HGD) after endoscopic resection (ER). In this study, we investigated the risk factors for pathological upgrades after ER and assessed the reason for these upgrades by retrospectively analyzing ER data between January 1999 and December 2019. We enrolled patients with LGD confirmed by forceps biopsy; the patients were classified into pathologically concordant (LGD) and upgraded (HGD and EGC) groups according to the pathology of their resected specimen. To determine the risk factors for upgrade, we compared the endoscopic findings of the concordant and upgraded groups via 1:1 matched case-control design. To find the reasons for discordance, all upgraded cases were pathologically re-evaluated. Among 1,643 cases of LGD, pathological upgrades were observed in 423 (25.7%) resected specimens and EGC was found in 111 (6.7%) lesions. After matching the upgraded and concordant cases, lesion sizes exceeding 1.5 cm (odds ratio (OR): 1.8; 95% CI: 1.1-3.0), mucosal nodularity (OR: 10.8; 95% CI: 5.6-21.0), heterogeneous color (OR: 3.0; 95% CI: 1.7-5.3), presence of erosion (OR: 2.7; 95% CI: 1.8-5.3), and open-type gastric atrophy (OR: 2.9; 95% CI: 1.7-4.9) were noted to be significantly associated with upgraded pathology to EGC. Among the EGC cases, 99 (89.2%) were found to have pre-existing dysplasia. In conclusion, endoscopic evaluations should be performed because of possible pathological upgrades and co-existence of carcinomas in LGDs, especially when they exhibit surface nodularity, erosion, heterogeneous color, and large size.https://doi.org/10.1371/journal.pone.0280735 |
| spellingShingle | Ga-Yeong Shin Jun Young Park Sung Hak Lee Yu Kyung Cho Myung-Gyu Choi Jae Myung Park Tumor heterogeneity and carcinoma in resected specimens of gastric low-grade dysplasia: A retrospective single center study. PLoS ONE |
| title | Tumor heterogeneity and carcinoma in resected specimens of gastric low-grade dysplasia: A retrospective single center study. |
| title_full | Tumor heterogeneity and carcinoma in resected specimens of gastric low-grade dysplasia: A retrospective single center study. |
| title_fullStr | Tumor heterogeneity and carcinoma in resected specimens of gastric low-grade dysplasia: A retrospective single center study. |
| title_full_unstemmed | Tumor heterogeneity and carcinoma in resected specimens of gastric low-grade dysplasia: A retrospective single center study. |
| title_short | Tumor heterogeneity and carcinoma in resected specimens of gastric low-grade dysplasia: A retrospective single center study. |
| title_sort | tumor heterogeneity and carcinoma in resected specimens of gastric low grade dysplasia a retrospective single center study |
| url | https://doi.org/10.1371/journal.pone.0280735 |
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