Abstract
BACKGROUND: The incidence of non-neoplastic pathology results is 5–10% after endoscopic resection (ER) of early gastric neoplasia. Complete removal of original tumor, incorrect localization, and pathology overestimation were main reasons for non-neoplastic pathology. However, pre-treatment characteristics for non-neoplastic pathology were not determined to date. AIMS: The aims of the study was to investigate predicting factors for non-neoplastic pathology. METHODS: Medical records of 865 patients who underwent ER for early gastric neoplasia between 2013 and 2016 were reviewed. A total of 949 cases of ER were performed during the study period. The incidence of non-neoplastic pathology was 8.7% per patients and 7.9% per lesions, respectively. Clinicopathologic data were compared between the patients who showed pathologic results or not at initial ER. RESULTS: Univariate analysis showed that whitish color, poor demarcation, flat gross appearance, adenoma with low grade dysplasia at forcep biopsy, and endoscopic mucosal resection were higher in the non-neoplastic pathology group. Open type atrophic gastritis, intestinal metaplasia and ulcer was lower in the non-neoplastic pathology group. After multivariate analysis, poor demarcation, non-prescence of ulcer, flat appearance, and adenoma with low grade dysplasia were significant contributable factors for non-neoplastic pathology. Considering beta coefficient,1 point was allocated in non-prescence of ulcer, flat appearance, and adenoma with low grade dysplasia. Two points were allocated in poor demarcation. Total points ranged from 0 to 5. Non-neoplastic pathology result in each point was as follows: point 0, 0.7% (1/139); point 1, 3.1% (6/193); point 2, 4.1% (14/344); point 3, 18.5% (22/199); point 4, 30.0% (6/20); point 5, 52.0% (26/50). Patients were categorized as low risk group (< 3) or high risk group (3 ≥) according to the total points. CONCLUSIONS: We developed a predictive model for non-neoplastic pathology results of ER. Rebiopsy or pathology re-evaluation is indicated in high risk group. FUNDING AGENCIES: None