title: A randomized trial to determine the diagnostic accuracy of conventional vs. jumbo forceps biopsy of gastric epithelial neoplasias before endoscopic submucosal dissection; open-label study.
abstract: OBJECTIVE
  Larger biopsy specimens or increasing the number of biopsies may improve the diagnostic accuracy of gastric epithelial neoplasia (GEN). The aims of this study was to compare the diagnostic accuracies between conventional and jumbo forceps biopsy of GEN before endoscopic submucosal dissection (ESD) and to confirm that increasing the number of biopsies is useful for the diagnosis of GEN.
  
  
  RESULTS
  The concordance rate between EFB and ESD specimens was not significantly different between the two groups [83.1 % (54/65) in JG vs. 79.1 % (53/67) in CG]. On multivariate analyses, two or four EFBs significantly increased the cumulating concordance rate [coefficients; twice: 5.1 (P = 0.01), four times: 5.9 (P = 0.02)]. But, the concordance rate was decreased in high grade dysplasia (coefficient -40.32, P = 0.006).
  
  
  METHODS
  One hundred and sixty GENs from 148 patients were randomized into two groups and finally 67 GENs in 61 patients and 65 GENs in 63 patients were allocated to the conventional group (CG) or jumbo group (JG), respectively. Four endoscopic forceps biopsy (EFB) specimens were obtained from each lesion with conventional (6.8 mm) forceps or jumbo (8 mm) forceps. The histological concordance rate between 4 EFB specimens and ESD specimens was investigated in the two groups.
  
  
  CONCLUSIONS
  Before ESD, the diagnostic accuracy of GENs was significantly increased not by the use of jumbo forceps biopsy but by increasing the number of biopsies.
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, Wonju, Gangwon-do, 220-701, Republic of Korea.
authors: Hyo Keun
authors: HK
authors: Jeon
authors: Ho Yoel
authors: HY
authors: Ryu
authors: Mee Yon
authors: MY
authors: Cho
authors: Hyun-Soo
authors: HS
authors: Kim
authors: Jae Woo
authors: JW
authors: Kim
authors: Hong Jun
authors: HJ
authors: Park
authors: Moon Young
authors: MY
authors: Kim
authors: Soon Koo
authors: SK
authors: Baik
authors: Sang Ok
authors: SO
authors: Kwon
authors: Su Yeon
authors: SY
authors: Park
authors: Sung Ho
authors: SH
authors: Won
mesh_terms: D000368:Aged; D001706:Biopsy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology*; D013525:Surgical Instruments