Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: a prospective short-term follow-up endoscopy study.
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.
Lee
Tae Hoon
TH
Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, South Korea.
Chung
Il Kwun
IK
Park
Ji Young
JY
Lee
Chang Kyun
CK
Lee
Suck Ho
SH
Kim
Hong Soo
HS
Park
Sang Heum
SH
Kim
Sun Joo
SJ
Cho
Hyun Deuk
HD
Hwangbo
Young
Y
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