title: Early-stage gastric cancers represented as dysplasia in a previous forceps biopsy: the importance of clinical management.
abstract: OBJECTIVE
  Because histological examination of gastric lesions by forceps biopsy is of limited accuracy, management on the basis of histological results is occasionally controversial. We examined the characteristics of early gastric cancers that presented as dysplasia resulting from a previous forceps biopsy.
  
  
  METHODS
  Between April 2007 and December 2010, 341 gastric adenocarcinoma lesions from 330 patients previously diagnosed histologically via endoscopic submucosal dissection were examined. We retrospectively assessed the characteristics of early gastric cancer according to their initial forceps biopsy results.
  
  
  RESULTS
  In total, 183 EGCs were diagnosed as dysplasia (53.7%; 89 low-grade and 94 high-grade) and 158 (46.3%) as carcinoma by forceps biopsy before endoscopic submucosal dissection. Significant differences were noted with respect to histologic differentiation of carcinomas, Lauren histologic type, depth of invasion, lymphovascular invasion, and en bloc resection between the dysplastic group and carcinoma group, based on forceps biopsy results.
  
  
  CONCLUSIONS
  A forceps biopsy result is not fully representative of the entire lesion and, thus, endoscopic submucosal dissection should be considered for lesions diagnosed as dysplasia via forceps biopsy in order to avoid the risk of missed carcinomas.
authors.affiliation: Digestive Disease Center, Soonchunhyang University College of Medicine, Bucheon and Seoul, Republic of Korea.
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Park
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Hong
authors.forename: Jae Pil
authors.initials: JP
authors.lastname: Han
authors.forename: Myung Soo
authors.initials: MS
authors.lastname: Kang
authors.forename: Hee Kyung
authors.initials: HK
authors.lastname: Kim
authors.forename: Jeong Ja
authors.initials: JJ
authors.lastname: Kwak
authors.forename: Bong Min
authors.initials: BM
authors.lastname: Ko
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Lee
authors.forename: Moon Sung
authors.initials: MS
authors.lastname: Lee
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000368:Aged; D055088:Early Detection of Cancer; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013525:Surgical Instruments