CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(12): E1683-E1690
DOI: 10.1055/a-1007-1730
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Optimal number of endoscopic biopsies for diagnosis of early gastric cancer

Masaki Nishitani
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
3  Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
,
Naohiro Yoshida
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Shigetsugu Tsuji
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Teppei Masunaga
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Hirokazu Hirai
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Saori Miyajima
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Akihiro Dejima
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Takashi Nakashima
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Shigenori Wakita
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Kenichi Takemura
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Hiroshi Minato
2  Department of Diagnostic Pathology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
,
Shuichi Kaneko
3  Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
,
Hisashi Doyama
1  Department of Gastroenterology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
› Author Affiliations
Further Information

Publication History

submitted 30 April 2019

accepted after revision 05 August 2019

Publication Date:
02 December 2019 (online)

  

Abstract

Background and study aims No recommendations are available for optimal number of endoscopic biopsies for early gastric cancer (GC), and whether detection of early GC is improved by increasing the number of biopsy is unclear. We therefore evaluated the relationship between number of biopsies and diagnostic accuracy.

Materials and methods We retrospectively evaluated 858 early GCs (623 from endoscopic submucosal dissection and 235 surgical specimens), which we classified as obtained after one, two, or three or more biopsies. We assessed diagnostic accuracy by number of biopsies, and in subgroups by tumor diameter, gross type, and surface color.

Results Almost half the lesions were obtained after one biopsy each, 30 % after two biopsies, and 20 % after three or more biopsies. Although diagnostic accuracy increased with biopsy number, it was significantly greater for the two-biopsy group than the one-biopsy group, (92.5 % vs. 83.9 %, P = 0.0009), but did not significantly differ between the two- and three or more-biopsy groups. This finding was seen when tumors were evaluated by size, but not by elevated type and surface color, for which more biopsies did not improve diagnostic accuracy. Multivariate analysis demonstrated that two or more biopsies was the independent significant factors for diagnostic accuracy.

Conclusions Two biopsies are the optimal number required to diagnose early GC.