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. 2018 Jul;29(4):481-487.
doi: 10.5152/tjg.2018.17347.

Endoscopic small-capacity forceps increase the pathological diagnosis of gastric indefinite neoplasia

Yasumasa Matsuo  1 , Hiroshi Yasuda  1 , Masaki Kato  1 , Hirofumi Kiyokawa  1 , Midori Ozawa  1 , Yoshinori Sato  1 , Yoshiko Ikeda  1 , Shun-Ichiro Ozawa  1 , Masaki Yamashita  1 , Takashi Fujino  2 , Hiroyuki Yamamoto  1 , Masayuki Takagi  2 , Fumio Itoh  1
Affiliations

Endoscopic small-capacity forceps increase the pathological diagnosis of gastric indefinite neoplasia

Yasumasa Matsuo et al. Turk J Gastroenterol. 2018 Jul.

Abstract

Background/aims: A definitive biopsy-based diagnosis of gastric cancer is sometimes difficult, and some cases are pathologically diagnosed as gastric indefinite neoplasia (GIN). The most appropriate forceps size for gastric biopsy has yet to be determined. In this study, we investigated the relation between the forceps size and the frequency of GIN diagnosis.

Materials and methods: The records of patients from two historical groups were reviewed. The first group comprised patients evaluated during the period when standard biopsy forceps (StF) were used (April 2010-March 2011), and the second group comprised patients evaluated during the period when small biopsy forceps (SmF) were used (April 2011-March 2013). Patients in whom GIN lesions were diagnosed with biopsy were identified, and pertinent data were compared between the two groups of patients.

Results: Among the 8,420 patients who underwent esophagogastroduodenoscopy (EGD) during the first period, 2,584 (30.7%) underwent gastric biopsy with StF. Among the 15,968 patients who underwent EGD during the second period, 4,204 (26.3%) underwent gastric biopsy with SmF. GIN was diagnosed in a significantly greater number of patients in the SmF group than in the StF group (52 [1.25%] vs. 19 [0.73%]; p=0.048). The mean minor-axis lengths of the biopsy samples were 1.50±0.50 mm and 1.38±0.40 mm in the StF group and the SmF group, respectively, with the SmF group samples tending to be shorter (p=0.088).

Conclusion: Because the SmF use may increase the rate of GIN diagnosis, the use of SmF with a standard-caliber endoscope should be avoided.

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Conflict of interest statement

Conflict of Interest: The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Flow diagram of patient selection for the study
Figure 2
Figure 2
Flow diagram of the clinical course after diagnosis of gastric indefinite neoplasia from lesion samples obtained by standard biopsy forceps
Figure 3
Figure 3
Flow diagram of the clinical course after diagnosis of gastric indefinite neoplasia from lesion samples obtained by small-capacity biopsy forceps
See this image and copyright information in PMC

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References

    1. Dixon MF. Gastrointestinal epithelial neoplasia: Vienna revisited. Gut. 2002;51:130–1. doi: 10.1136/gut.51.1.130. - DOI - PMC - PubMed
    1. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12. doi: 10.1007/s10120-011-0041-5. - DOI - PubMed
    1. Endoscopic Classification Review Group. Update on the Paris classification of superficial neoplastic lesions in the digestive tract. Endoscopy. 2005;37:570–8. doi: 10.1055/s-2005-861352. - DOI - PubMed
    1. Bernstein DE, Barkin JS, Reiner DK, et al. Standard biopsy forceps versus large-capacity forceps with and without needle. Gastrointest Endosc. 1995;41:573–6. doi: 10.1016/S0016-5107(95)70193-1. - DOI - PubMed
    1. Danesh BJ, Burke M, Newman J, et al. Comparison of weight, depth, and diagnostic adequacy of specimens obtained with 16 different biopsy forceps designed for upper gastrointestinal endoscopy. Gut. 1985;26:227–31. doi: 10.1136/gut.26.3.227. - DOI - PMC - PubMed