title: Endoscopic predictors for undifferentiated histology in differentiated gastric neoplasms prior to endoscopic resection.
abstract: BACKGROUND
  There is often a discrepancy between results from endoscopic forceps biopsy and resected specimen. We aimed to identify endoscopic predictors for undifferentiated histology in differentiated gastric neoplasms prior to endoscopic resection.
  
  
  METHODS
  Medical records of the patients who underwent endoscopic submucosal dissection (ESD) for biopsy-proven differentiated gastric neoplasms at Seoul National University Hospital between July 2005 and July 2014 were retrospectively reviewed. The lesions were divided into two groups based on the final histologic result of ESD: differentiated adenocarcinoma (DA group) and undifferentiated histology (UDH group). The discordant rate, clinicopathologic characteristics, and endoscopic factors were analyzed.
  
  
  RESULTS
  A total of 1641 early gastric cancers from 1615 patients were included. Of these, 1556 (94.8%) were diagnosed as DA and 85 (5.2%) as UDH. The mean age was significantly lower, and number of women was higher in the UDH group than in the DA group. On multivariate analysis, age <65 years [odds ratio (OR) 1.75, 95 % confidence interval (CI) 1.10-2.80], female sex (OR 3.19, 95% CI 2.00-5.08), endoscopic size >10 mm (OR 1.81, 95% CI 1.12-2.92), depressed type (OR 2.85, 95% CI 1.56-5.21), nodularity (OR 2.83, 95% CI 1.59-5.05), and whitish discoloration (OR 19.64, 95% CI 6.98-55.25) were independent predictors.
  
  
  CONCLUSIONS
  Female sex, age <65 years, large endoscopic size, depressed morphology, surface nodularity, and whitish discoloration were predictors for UDH. Meticulous attention should be paid to the lesions with these endoscopic predictors for determining the risk of UDH prior to endoscopic resection.
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Daehangno 101, Jongno-gu, Seoul, 110-744, South Korea.
authors: Ji Min
authors: JM
authors: Choi
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Daehangno 101, Jongno-gu, Seoul, 110-744, South Korea. harley1333@hanmail.net.
authors: Sang Gyun
authors: SG
authors: Kim
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Daehangno 101, Jongno-gu, Seoul, 110-744, South Korea.
authors: Hyo-Joon
authors: HJ
authors: Yang
authors: Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea.
authors: Joo Hyun
authors: JH
authors: Lim
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Daehangno 101, Jongno-gu, Seoul, 110-744, South Korea.
authors: Jeongmin
authors: J
authors: Choi
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Daehangno 101, Jongno-gu, Seoul, 110-744, South Korea.
authors: Jong Pil
authors: JP
authors: Im
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Daehangno 101, Jongno-gu, Seoul, 110-744, South Korea.
authors: Joo Sung
authors: JS
authors: Kim
authors: Department of Pathology, Seoul National University College of Medicine, Seoul, South Korea.
authors: Woo Ho
authors: WH
authors: Kim
authors: Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Daehangno 101, Jongno-gu, Seoul, 110-744, South Korea.
authors: Hyun Chae
authors: HC
authors: Jung
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery*; D000367:Age Factors; D000368:Aged; D001706:Biopsy / Q000379:methods; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D013270:Stomach / Q000473:pathology* / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: Biopsy; Endoscopy resection; Stomach neoplasms; Undifferentiated histology