title: Treatment strategy for gastric non-invasive intraepithelial neoplasia diagnosed by endoscopic biopsy.
abstract: Treatment strategies, whether as follow-up or "total incisional biopsy" for gastric noninvasive intraepithelial neoplasia diagnosed by examination of an endoscopic forceps biopsy specimen, are controversial due to problems associated with the diagnostic accuracy of endoscopic forceps biopsy and questions about the safety and efficacy of endoscopic treatment. Based on the histological findings of the biopsy specimen, it is difficult to differentiate between reactive or regenerative changes, inflammation and neoplastic changes, intraepithelial and invasive tumors. Therefore, gastric neoplasia diagnosed as noninvasive intraepithelial often develop into invasive carcinoma during follow-up. Recent advances in endoscopic modalities and treatment devices, such as image-enhanced endoscopy and high-frequency generators, may make endoscopic treatment, such as endoscopic submucosal dissection (ESD), a therapeutic option for gastric intraepithelial neoplasia, including low-grade neoplasms. Future studies are required to evaluate whether ESD is a valid strategy for gastric intraepithelial neoplasm with regard to safety and cost effectiveness.
authors.affiliation: Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishida
authors.forename: Shusaku
authors.initials: S
authors.lastname: Tsutsui
authors.forename: Motohiko
authors.initials: M
authors.lastname: Kato
authors.forename: Takuya
authors.initials: T
authors.lastname: Inoue
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Akasaka
authors.forename: Takuya
authors.initials: T
authors.lastname: Yamada
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Shinzaki
authors.forename: Hideki
authors.initials: H
authors.lastname: Iijima
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tsujii
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara