Endoscopic characteristics of gastric adenomas suggesting carcinomatous transformation.
BACKGROUND
Currently, endoscopic resections, including endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD), are widely performed for the management of gastric neoplasia. This study aimed to evaluate the potential predictive factors for carcinomas on the basis of endoscopic features.


METHODS
This study investigated 114 samples from 114 patients. Gastric adenoma was diagnosed initially for all the patients. The endoscopic findings were reviewed for location, size, gross appearance, surface nodularity, ulceration, surface color, and number of biopsy samples. These variables were analyzed and compared between an adenoma group (51 cases) and a carcinoma group (63 cases) on the basis of postresection diagnosis.


RESULTS
The mean age of the patients was 62 years (range, 43-82 years), and 83 of the patients were men. The diameter of the lesions was 14.6 +/- 8.2 mm in the adenoma group and 15.4 +/- 7.4 mm in the carcinoma group. Depressed type, combined high-grade dysplasia, red discoloration, and mucosal ulceration were significant variables associated with carcinomas. In the multivariate analysis, combined high-grade dysplasia was a significant independent predictor of carcinomas.


CONCLUSIONS
The results suggest that patients with high-grade dysplasia on forceps biopsies should be considered candidates for endoscopic resection. Characteristics of gastric adenomas such as a depressed type, red color, and ulceration that may have foci of carcinomas in other parts of the adenomas also should be considered for endoscopic resection.
Jung
Min Kyu
MK
Department of Internal Medicine, Kyungpook National University Hospital, 50 Samduk 2-Ga, Chung-gu, Daegu, 700-721, South Korea. minky1973@kornet.net
Jeon
Seong Woo
SW
Park
Soo Young
SY
Cho
Chang Min
CM
Tak
Won Young
WY
Kweon
Young Oh
YO
Kim
Sung Kook
SK
Choi
Yong Hwan
YH
Bae
Han Ik
HI
D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000236:Adenoma / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D003937:Diagnosis, Differential; D018450:Disease Progression; D004210:Dissection / Q000379:methods; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D013276:Stomach Ulcer / Q000209:etiology / Q000473:pathology