Nishida T, Tsutsui S, Kato M, Inoue T, Yamamoto S, Hayashi Y, Akasaka T, Yamada T, Shinzaki S, Iijima H, Tsujii M, Takehara T. Treatment strategy for gastric non-invasive intraepithelial neoplasia diagnosed by endoscopic biopsy. World J Gastrointest Pathophysiol 2011; 2(6): 93-99 [PMID: 22180842 DOI: 10.4291/wjgp.v2.i6.93]
Corresponding Author of This Article
Tetsuo Takehara, MD, PhD, Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. takehara@gh.med.osaka-u.ac.jp
Article-Type of This Article
Editorial
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/
Tsutomu Nishida, Shusaku Tsutsui, Motohiko Kato, Takuya Inoue, Shunsuke Yamamoto, Yoshito Hayashi, Tomofumi Akasaka, Takuya Yamada, Shinichiro Shinzaki, Hideki Iijima, Masahiko Tsujii, Tetsuo Takehara, Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan
Author contributions: Nishida T wrote the manuscript; Nishida T, Tsusui S and Kato M researched the content; Inoue T, Yamamoto S, Hayashi Y, Akasaka T, Yamada T and Shinzaki S contributed equally to this work; Iijima H, Tsujii M and Takehara T provided scientific editing and assisted with writing the manuscript.
Correspondence to: Tetsuo Takehara, MD, PhD, Department of Gastroenterology and Hepatology, Clinical Research Building (K1), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. takehara@gh.med.osaka-u.ac.jp
Telephone: +81-6-68793621 Fax: +81-6-68793629
Received: May 2, 2011 Revised: September 26, 2011 Accepted: October 3, 2011 Published online: December 15, 2011
Abstract
Treatment strategies, whether as follow-up or “total incisional biopsy” for gastric noninvasive intraepithelial neoplasia diagnosed by examination of an endoscopic forceps biopsy specimen, are controversial due to problems associated with the diagnostic accuracy of endoscopic forceps biopsy and questions about the safety and efficacy of endoscopic treatment. Based on the histological findings of the biopsy specimen, it is difficult to differentiate between reactive or regenerative changes, inflammation and neoplastic changes, intraepithelial and invasive tumors. Therefore, gastric neoplasia diagnosed as noninvasive intraepithelial often develop into invasive carcinoma during follow-up. Recent advances in endoscopic modalities and treatment devices, such as image-enhanced endoscopy and high-frequency generators, may make endoscopic treatment, such as endoscopic submucosal dissection (ESD), a therapeutic option for gastric intraepithelial neoplasia, including low-grade neoplasms. Future studies are required to evaluate whether ESD is a valid strategy for gastric intraepithelial neoplasm with regard to safety and cost effectiveness.
