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©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jan 28, 2019; 25(4): 469-484
Published online Jan 28, 2019. doi: 10.3748/wjg.v25.i4.469
Published online Jan 28, 2019. doi: 10.3748/wjg.v25.i4.469
Treatment for gastric ‘indefinite for neoplasm/dysplasia’ lesions based on predictive factors
Mi Jung Kwon, Hye-Rim Park, Soo Kee Min, Jin won Seo, Ji-Young Choe, Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, South Korea
Ho Suk Kang, Hyeon Tae Kim, Jin Woo Choo, Bo Hyun Lee, Sung Eun Hong, Kun Ha Park, Dong Min Jung, Hyun Lim, Jae Seung Soh, Sung Hoon Moon, Jong Hyeok Kim, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang-si 431-796, South Korea
Author contributions: Kwon MJ and Kang HS designed the study, analyzed the data and drafted the manuscript; Kim HT, Choo JW, Lee BH, Hong SE, Park KH, Jung DM collected the data; Soh JS and Lim H revised the manuscript for important intellectual content; Park HR, Min SK, Seo JW, Choe JW and Kwon MJ reviewed the pathologic slides; Moon SH and Kim JH supervised the study; all authors have read and approved the final version of the manuscript to be published.
Institutional review board statement: This study was conducted with the approval of the ethics committee of Hallym University Sacred Heart Hospital in Anyang, South Korea. IRB No. HALLYM 2018-01-003-001.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: 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/
Corresponding author: Ho Suk Kang, MD, Assistant Professor, Division of Gastroenterology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si 431-796, South Korea. hskang76@hallym.or.kr
Telephone: +82-31-3803707 Fax: +82-31-3803701
Received: October 27, 2018
Peer-review started: October 29, 2018
First decision: November 29, 2018
Revised: December 31, 2018
Accepted: January 9, 2019
Article in press: January 10, 2019
Published online: January 28, 2019
Peer-review started: October 29, 2018
First decision: November 29, 2018
Revised: December 31, 2018
Accepted: January 9, 2019
Article in press: January 10, 2019
Published online: January 28, 2019
Core Tip
Core tip: At initial biopsy, ‘indefinite for neoplasm/dysplasia’ (IFND) lesions proved to be adenocarcinomas (22.6%). Independent risk factors for gastric IFND cancer were age (≥ 60 years), endoscopic size (≥ 10 mm), single lesion, spontaneous bleeding, atypical epithelia, and repeated IFND diagnosis. Additionally, fold change predicted undifferentiated or invasive carcinoma in the submucosal layers or deeper. However, diagnostic delays shorter than 1 year were not associated with worse prognoses. In summary, for IFND lesions with these features, endoscopic resection may be a better option than repeated endoscopic biopsy. In the absence of associated risk factors, accurate diagnosis through follow-up within 1 year is recommended.