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Endoscopic and histological evaluation of group iii lesions by strip biopsy



Endoscopic and histological evaluation of group iii lesions by strip biopsy



Gastroenterological Endoscopy 30(1): 44-56



In order to confirm the correct diagnosis of gastric malignancy, strip biopsy was performed in 73 gastric lesions diagnosed as Group III and IV histologically in the bite biopsy specimen. Then, some cancerous lesions were detected in these cases. In these cancer cases misdiagnosed as Group III lesions, the reason and background of false negative diagnosis were investigated pathologically. Moreover, endoscopic differential findings between cancer and atypical epithelial lesions were studied in these cases based on the diagnosis by strip biopsy. 1) By the histological studies in strip biopsy specimen, 74.0% of these lesions were diagnosed as well as differentiated adenocarcinoma, 9.6% as border line lesions and only 16.4% as adenoma. This paper deals with border line lesions and adenoma as atypical epithelial lesion. 2) In the newly diagnosed 54 cancer lesions, the cellular and structural atypism were investigated in strip biopsy specimen as compared with bite biopsy one. The histological pattern that the cellular atypism was moderate but the structural atypism was remarkable were observed in the local area of 28 out of 54 gastric cancer lesions. In these cases, it seemed that there was a tendency for these to be faultily diagnosed as Group III lesions and that it was difficult to differentiated such gastric cancers endoscopically from on atypical epithelial lesions. 3) In the retrospective endoscopic study on these lesions diagnosed by strip biopsy, the lesions that the surface was constituted by more than two curved dimensions had a high possibility of cancer, but the lesions that the surface was constituted by one curved dimension, in spite of many divisions, had a high possibility of atypical epithelial lesion. All lesions depressed in shape were cancer.

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