title: Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: a prospective short-term follow-up endoscopy study.
abstract: OBJECTIVE
  To investigate the relationship between post-endoscopic resection (ER) scars on magnifying endoscopy (ME) and the pathological diagnosis in order to validate the clinical significance of ME.
  
  
  METHODS
  From January, 2007 to June, 2008, 124 patients with 129 post-ER scar lesions were enrolled. Mucosal pit patterns on ME were compared with conventional endoscopy (CE) findings and histological results obtained from targeted biopsies.
  
  
  RESULTS
  CE findings showed nodular scars (53/129), erythematous scars (85/129), and ulcerative scars (4/129). The post-ER scars were classified into four pit patterns of sulci and ridges on ME: (I) 47 round; (II) 54 short rod or tubular; (III) 19 branched or gyrus-like; and (IV) 9 destroyed pits. Sensitivity and specificity were 88.9% and 62.5%, respectively, by the presence of nodularity on CE. Erythematous lesions were high sensitivity (100%), but specificity was as low as 36.7%. The range of the positive predictive value (PPV) on CE was as low as 10.6%-25%. Nine type IV pit patterns were diagnosed as tumor lesions, and 120 cases of type I-III pit patterns revealed non-neoplastic lesions. Thus, the sensitivity, specificity, and the PPV of ME were 100%.
  
  
  CONCLUSIONS
  ME findings can detect the presence of tumor in post-ER scar lesions, and make evident the biopsy target site in short-term follow-up. Further large-scale and long-term studies are needed to determine whether ME can replace endoscopic biopsy.
authors.affiliation: Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, South Korea.
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.forename: Il Kwun
authors.initials: IK
authors.lastname: Chung
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
authors.forename: Chang Kyun
authors.initials: CK
authors.lastname: Lee
authors.forename: Suck Ho
authors.initials: SH
authors.lastname: Lee
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sang Heum
authors.initials: SH
authors.lastname: Park
authors.forename: Sun Joo
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hyun Deuk
authors.initials: HD
authors.lastname: Cho
authors.forename: Young
authors.initials: Y
authors.lastname: Hwangbo
mesh_terms: D000368:Aged; D001706:Biopsy; D002921:Cicatrix / Q000209:etiology / Q000473:pathology; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D005753:Gastric Mucosa / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology