title: Clinical impact of strip biopsy for early gastric cancer.
abstract: BACKGROUND
  The impact of EMR (strip biopsy method) on the selection of subsequent treatment for early gastric cancer was analyzed retrospectively.
  
  
  METHODS
  A total of 163 consecutive patients with gastric epithelial tumors (186 lesions) underwent strip biopsy. On the basis of pretherapeutic findings, the indications for strip biopsy were classified into 4 groups: benign-malignant borderline group (93 lesions), curative indication group (65), diagnostic indication group (22), and palliative indication group (6). The clinical impact of the strip biopsy result on the subsequent treatment strategy was assessed.
  
  
  RESULTS
  Of the lesions in the benign-malignant borderline group, 36.6% were intramucosal cancer. In the curative indication group, the results of strip biopsy differed from the pretherapeutic findings for 7.7% of the lesions. Strip biopsy was effective treatment for all lesions in the benign-malignant borderline group and for 92.3% of those in the curative indication group. Strip biopsy avoided unnecessary surgery in 50% of patients in the diagnostic indication group and 16.7% of those in the palliative indication group. After the strip biopsy results were explained, 50% of the patients in the palliative indication group reversed their initial decision and opted for surgery. Strip biopsy results reversed the decision for surgery, which had been based on inaccurate pretherapeutic information, in 20% of cases of early gastric cancer.
  
  
  CONCLUSIONS
  Strip biopsy has a major clinical impact, because it provides an accurate diagnosis, aids in the selection of an appropriate treatment strategy, and reduces unnecessary surgery.
authors.affiliation: Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, Ube, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Yanai
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Matsubara
authors.forename: Toyokazu
authors.initials: T
authors.lastname: Kawano
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okamoto
authors.forename: Atsuyoshi
authors.initials: A
authors.lastname: Hirano
authors.forename: Youhei
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Jun
authors.initials: J
authors.lastname: Nishikawa
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Okita
mesh_terms: D001706:Biopsy; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D009361:Neoplasm Invasiveness; D010166:Palliative Care; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography