title: The diagnostic accuracy of endoscopic biopsy for gastric dysplasia.
abstract: OBJECTIVE
  There is controversy over the treatment for low grade dysplasia, while resection is recommended for high grade dysplasia. But the concordance of the grade of dysplasia between pre- and post-resection is low because of sampling errors with endoscopic biopsy. We attempted to establish a clearer direction for the treatment of dysplasia by clarifying the discrepancy between the pre- and post-resection diagnoses.
  
  
  METHODS
  We performed a retrospective review of 126 patients who had undergone resection with the diagnosis of dysplasia on biopsy at Bundang CHA Hospital from 1999 to 2009.
  
  
  RESULTS
  Seventy patients were diagnosed with low grade dysplasia and 56 patients were diagnosed with high grade dysplasia. Among the 33 patients who received gastrectomy with lymph node dissection, 30 patients were revealed to have invasive cancers and 4 patients showed lymph node metastasis. Discordance between the diagnoses from biopsy and resection occurred in 55 patients (44%). There was no correlation on the comparative analysis between the size, location or gross type of lesion and the grade of dysplasia.
  
  
  CONCLUSIONS
  The rate of discordance between the diagnoses of endoscopic biopsy and the post resection pathologic report was as high as 44%. Endoscopic mucosal resection was not sufficient for some patients who were diagnosed with dysplasia on biopsy due to the presence of lymph node metastasis. It is necessary to be prudent when determining the follow-up and treatment based solely on the result of the biopsy.
authors.affiliation: Department of Surgery, College of Medicine, CHA University, Seongnam, Korea.
authors.forename: Sung Bae
authors.initials: SB
authors.lastname: Lee
authors.forename: Hye Yun
authors.initials: HY
authors.lastname: Kang
authors.forename: Kwang Il
authors.initials: KI
authors.lastname: Kim
authors.forename: Dae Ho
authors.initials: DH
authors.lastname: Ahn
references.citation: Scand J Gastroenterol. 1996 Jul;31(7):711-5
references.pmid: 8819223
references.citation: Cancer Res. 1993 Mar 15;53(6):1317-21
references.pmid: 8443811
references.citation: Br J Cancer. 1991 May;63(5):765-8
references.pmid: 2039701
references.citation: Am J Surg Pathol. 1988 Feb;12(2):96-114
references.pmid: 3341515
references.citation: Am J Surg Pathol. 1984 May;8(5):381-91
references.pmid: 6375403
references.citation: Endoscopy. 1993 May;25(4):261-4
references.pmid: 8330542
references.citation: Gut. 2000 Aug;47(2):251-5
references.pmid: 10896917
references.citation: Cancer. 1984 Nov 1;54(9):1794-801
references.pmid: 6478415
references.citation: Pathol Res Pract. 1994 Jan;190(1):61-8
references.pmid: 8065990
references.citation: J Clin Pathol. 1980 Aug;33(8):711-21
references.pmid: 7430384
references.citation: J Pathol. 1993 Jan;169(1):73-8
references.pmid: 8433217