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
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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
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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.
