title: Is endoscopic mucosal resection a sufficient treatment for low-grade gastric epithelial dysplasia?
abstract: OBJECTIVE
  The rate of diagnosis of gastric adenoma has increased because esophagogastroduodenoscopy is being performed at an increasingly greater frequency. However, there are no treatment guidelines for low-grade dysplasia (LGD). To determine the appropriate treatment for LGD, we evaluated the risk factors associated with the categorical upgrade from LGD to high grade dysplasia (HGD)/early gastric cancer (EGC) and the risk factors for recurrence after endoscopic treatment.
  
  
  METHODS
  We compared the complication rates, recurrence rates, and remnant lesions in 196 and 56 patients treated with endoscopic submucosal dissection (ESD) and endoscopic mucosal resection (EMR), respectively, by histologically confi rming low-grade gastric epithelial dysplasia.
  
  
  RESULTS
  The en bloc resection rate was significantly lower in the EMR group (31.1%) compared with the ESD group (75.0%) (p<0.001). However, no significant difference was observed in the prevalence of remnant lesions or recurrence rate (p=0.911) of gastric adenoma. The progression of LGD to HGD or EGC caused an increase in the incidence of tumor lesions >1 cm with surface redness and depressions.
  
  
  CONCLUSIONS
  For the treatment of LGD, EMR resulted in a higher incidence of uncertain resection margins and a lower en bloc resection rate than ESD. However, there was no signifi cant difference in recurrence rate.
authors.affiliation: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors.forename: Seul Young
authors.initials: SY
authors.lastname: Kim
authors.forename: Jae Kue
authors.initials: JK
authors.lastname: Sung
authors.forename: Hee Seok
authors.initials: HS
authors.lastname: Moon
authors.forename: Kyu Seop
authors.initials: KS
authors.lastname: Kim
authors.forename: Il Soon
authors.initials: IS
authors.lastname: Jung
authors.forename: Beom Yong
authors.initials: BY
authors.lastname: Yoon
authors.forename: Beom Hee
authors.initials: BH
authors.lastname: Kim
authors.forename: Kwang Hun
authors.initials: KH
authors.lastname: Ko
authors.forename: Hyun Yong
authors.initials: HY
authors.lastname: Jeong