Clinical impact of strip biopsy for early gastric cancer.
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.
Yanai
Hideo
H
Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine, Ube, Japan.
Matsubara
Yoshitaka
Y
Kawano
Toyokazu
T
Okamoto
Takeshi
T
Hirano
Atsuyoshi
A
Nakamura
Youhei
Y
Nakamura
Hiroki
H
Nishikawa
Jun
J
Okita
Kiwamu
K
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