Lee TH, Chung IK, Park JY, Lee CK, Lee SH, Kim HS, Park SH, Kim SJ, Cho HD, Hwangbo Y. Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study. World J Gastroenterol 2009; 15(3): 349-355 [PMID: 19140236 DOI: 10.3748/wjg.15.349]
Corresponding Author of This Article
Il-Kwun Chung, MD, Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-dong, Cheonan, 330-721, South Korea. euschung@schca.ac.kr
Article-Type of This Article
Brief Articles
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Lee TH, Chung IK, Park JY, Lee CK, Lee SH, Kim HS, Park SH, Kim SJ, Cho HD, Hwangbo Y. Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study. World J Gastroenterol 2009; 15(3): 349-355 [PMID: 19140236 DOI: 10.3748/wjg.15.349]
World J Gastroenterol. Jan 21, 2009; 15(3): 349-355 Published online Jan 21, 2009. doi: 10.3748/wjg.15.349
Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study
Tae Hoon Lee, Il-Kwun Chung, Ji-Young Park, Chang Kyun Lee, Suck-Ho Lee, Hong Soo Kim, Sang-Heum Park, Sun-Joo Kim, Hyun-Deuk Cho, Young Hwangbo
Tae Hoon Lee, Il-Kwun Chung, Ji-Young Park, Chang Kyun Lee, Suck-Ho Lee, Hong Soo Kim, Sang-Heum Park, Sun-Joo Kim, Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-dong, Cheonan, 330-721, South Korea
Hyun-Deuk Cho, Department of Pathology, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-dong, Cheonan, 330-721, South Korea
Young Hwangbo, Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-dong, Cheonan, 330-721, South Korea
Author contributions: Lee TH and Chung IK contributed equally to this work; Park JY, Lee CK, Lee SH, Kim HS, Park SH and Kim SJ provided clinical advice; Lee TH, Chung IK, Cho HD and Hwangbo Y performed the research; Lee TH and Chung IK wrote the paper.
Correspondence to: Il-Kwun Chung, MD, Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-dong, Cheonan, 330-721, South Korea. euschung@schca.ac.kr
Telephone: +82-41-570-3741
Fax: +82-41-574-5762
Received: November 4, 2008 Revised: December 10, 2008 Accepted: December 17, 2008 Published online: January 21, 2009
Abstract
AIM: To investigate the relationship between post-endoscopic resection (ER) scars on magnifying endoscopy (ME) and the pathological diagnosis in order to validate the clinical significance of ME.
METHODS: From January, 2007 to June, 2008, 124 patients with 129 post-ER scar lesions were enrolled. Mucosal pit patterns on ME were compared with conventional endoscopy (CE) findings and histological results obtained from targeted biopsies.
RESULTS: CE findings showed nodular scars (53/129), erythematous scars (85/129), and ulcerative scars (4/129). The post-ER scars were classified into four pit patterns of sulci and ridges on ME: (I) 47 round; (II) 54 short rod or tubular; (III) 19 branched or gyrus-like; and (IV) 9 destroyed pits. Sensitivity and specificity were 88.9% and 62.5%, respectively, by the presence of nodularity on CE. Erythematous lesions were high sensitivity (100%), but specificity was as low as 36.7%. The range of the positive predictive value (PPV) on CE was as low as 10.6%-25%. Nine type IV pit patterns were diagnosed as tumor lesions, and 120 cases of type I-III pit patterns revealed non-neoplastic lesions. Thus, the sensitivity, specificity, and the PPV of ME were 100%.
CONCLUSION: ME findings can detect the presence of tumor in post-ER scar lesions, and make evident the biopsy target site in short-term follow-up. Further large-scale and long-term studies are needed to determine whether ME can replace endoscopic biopsy.
