title: Evaluation of endoscopic findings for discriminating between early carcinomas and low-grade adenomas in superficial elevated gastric lesions.
abstract: OBJECTIVE
  This study aimed to determine the useful endoscopic findings in a differential diagnosis between early carcinomas (EC) and low-grade adenomas (LGA) in superficial elevated gastric epithelial neoplasia during conventional endoscopy with white-light imaging (C-WLI).
  
  
  METHODS
  We investigated 270 consecutive cases of superficial elevated gastric epithelial neoplasias, which were removed by endoscopic submucosal dissection. The pathological diagnostic criteria were based on the revised Vienna classification: category 4 (mucosal high-grade neoplasia) or 5 (submucosal invasion by carcinoma) lesions were diagnosed as EC, while category 3 (mucosal low-grade neoplasia) lesions were diagnosed as LGA. The association between the postoperative pathological diagnoses (EC or LGA) and the following endoscopic findings: localized site, lesion size, color (reddish or whitish), shape (smooth, petal, or irregular), and presences of depression, erosion, ulceration, or nodularity on the surface, were evaluated.
  
  
  RESULTS
  Of 270 epithelial neoplasias, 222 (58 LGA and 164 EC) were retrospectively evaluated. Multiple logistic regression analysis revealed that the lesion size [odds ratio (OR), 1.216; p<0.001) and reddish color (OR, 5.274; p<0.001) were independent findings for EC.
  
  
  CONCLUSIONS
  The lesion size and reddish color were useful optical findings for discriminating between EC and LGA.
authors: Division of Gastroenterology, Yokohama City University Hospital, Yokohama, Japan. inamorim@med.yokohama-cu.ac.jp.
authors: Takashi
authors: T
authors: Nonaka
authors: Masahiko
authors: M
authors: Inamori
authors: Kenji
authors: K
authors: Kanoshima
authors: Kanji
authors: K
authors: Ohkuma
authors: Yumi
authors: Y
authors: Inoh
authors: Mizue
authors: M
authors: Matsuura
authors: Akiko
authors: A
authors: Fuyuki
authors: Shiori
authors: S
authors: Uchiyama
authors: Takuma
authors: T
authors: Higurashi
authors: Hidenori
authors: H
authors: Ohkubo
authors: Hiroshi
authors: H
authors: Iida
authors: Hiroki
authors: H
authors: Endo
authors: Yoko
authors: Y
authors: Tateishi
authors: Akihiko
authors: A
authors: Kusakabe
authors: Kenichi
authors: K
authors: Ohashi
authors: Shin
authors: S
authors: Maeda
authors: Atsushi
authors: A
authors: Nakajima
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D000069916:Endoscopic Mucosal Resection; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery