Journal of Gastric Cancer

  • 제11권3호
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  • Pages.155-161
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  • 2011
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  • 2093-582X(pISSN)
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  • 2093-5641(eISSN)
대한위암학회 (The Korean Gastric Cancer Association)
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Frozen Section Biopsy to Evaluation of Obscure Lateral Resection Margins during Gastric Endoscopic Submucosal Dissection for Early Gastric Cancer

  • Kang, Eun-Jung (Institute for Digestive Research, Digestive Disease Center) ;
  • Cho, Joo-Young (Institute for Digestive Research, Digestive Disease Center) ;
  • Lee, Tae-Hee (Institute for Digestive Research, Digestive Disease Center) ;
  • Jin, So-Young (Department of Pathology, Soonchunhyang University College of Medicine) ;
  • Cho, Won-Young (Institute for Digestive Research, Digestive Disease Center) ;
  • Bok, Jin-Hyun (Institute for Digestive Research, Digestive Disease Center) ;
  • Kim, Hyun-Gun (Institute for Digestive Research, Digestive Disease Center) ;
  • Kim, Jin-Oh (Institute for Digestive Research, Digestive Disease Center) ;
  • Lee, Joon-Seong (Institute for Digestive Research, Digestive Disease Center) ;
  • Lee, Il-Hyun (Institute for Statistics and Education Consulting, StatEdu)
  • 투고 : 2011.06.10
  • 심사 : 2011.09.01
  • 발행 : 2011.09.30
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초록

Purpose: To determine the diagnostic utility of a frozen section biopsy in patients undergoing endoscopic submucosal dissection (ESD) for early gastric neoplasms with obscure margins even with chromoendoscopy using acetic acid and indigo carmine (AI chromoendoscopy). Materials and Methods: The lateral spread of early gastric neoplasms was unclear even following AI chromoendoscopy in 38 patients who underwent ESD between June 2007 and May 2011. Frozen section biopsies were obtained by agreement of the degree of lateral spread between two endoscopists. Thus, frozen section biopsies were obtained from 23 patients (FBx group) and not in the other 15 patients (AI group). Results: No significant differences were observed for size, histology, invasive depth, and location of lesions between the AI and FBx groups. No false positive or false negative results were observed in the frozen section diagnoses. Adenocarcinoma was revealed in three patients and tubular adenoma in one, thereby changing the delineation of lesion extent and achieving free lateral margins. The rates of free lateral resection margins and curative resection were significantly higher in the FBx group than those in the AI group. Conclusions: Frozen section biopsy can help endoscopists perform more safe and accurate ESD in patients with early gastric neoplasm.

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참고문헌

  1. Nakayoshi T, Tajiri H, Matsuda K, Kaise M, Ikegami M, Sasaki H. Magnifying endoscopy combined with narrow band imaging system for early gastric cancer: correlation of vascular pattern with histopathology (including video). Endoscopy 2004;36:1080-1084. https://doi.org/10.1055/s-2004-825961
  2. Tamai N, Kaise M, Nakayoshi T, Katoh M, Sumiyama K, Gohda K, et al. Clinical and endoscopic characterization of depressed gastric adenoma. Endoscopy 2006;38:391-394. https://doi.org/10.1055/s-2005-921207
  3. Otsuka Y, Niwa Y, Ohmiya N, Ando N, Ohashi A, Hirooka Y, et al. Usefulness of magnifying endoscopy in the diagnosis of early gastric cancer. Endoscopy 2004;36:165-169. https://doi.org/10.1055/s-2004-814184
  4. Yao K, Anagnostopoulos GK, Ragunath K. Magnifying endoscopy for diagnosing and delineating early gastric cancer. Endoscopy 2009;41:462-467. https://doi.org/10.1055/s-0029-1214594
  5. Yagi K, Aruga Y, Nakamura A, Sekine A, Umezu H. Th e study of dynamic chemical magnifying endoscopy in gastric neoplasia. Gastrointest Endosc 2005;62:963-969. https://doi.org/10.1016/j.gie.2005.08.050
  6. Sakai Y, Eto R, Kasanuki J, Kondo F, Kato K, Arai M, et al. Chromoendoscopy with indigo carmine dye added to acetic acid in the diagnosis of gastric neoplasia: a prospective comparative study. Gastrointest Endosc 2008;68:635-641. https://doi.org/10.1016/j.gie.2008.03.1065
  7. Yamashita H, Kitayama J, Ishigami H, Yamada J, Miyato H, Kaisaki S, et al. Endoscopic instillation of indigo carmine dye with acetic acid enables the visualization of distinct margin of superfi cial gastric lesion; Usefulness in endoscopic treatment and diagnosis of gastric cancer. Dig Liver Dis 2007;39:389-391. https://doi.org/10.1016/j.dld.2006.12.012
  8. Iizuka T, Kikuchi D, Hoteya S, Yahagi N. The acetic acid + indigocarmine method in the delineation of gastric cancer. J Gastroenterol Hepatol 2008;23:1358-1361. https://doi.org/10.1111/j.1440-1746.2008.05528.x
  9. Kawahara Y, Takenaka R, Okada H, Kawano S, Inoue M, Tsuzuki T, et al. Novel chromoendoscopic method using an acetic acid-indigocarmine mixture for diagnostic accuracy in delineating the margin of early gastric cancers. Dig Endosc 2009;21:14-19. https://doi.org/10.1111/j.1443-1661.2008.00824.x
  10. Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma - 2nd English Edition -. Gastric Cancer 1998;1:10-24.
  11. Kuznetsov K, Lambert R, Rey JF. Narrow-band imaging: potential and limitations. Endoscopy 2006;38:76-81. https://doi.org/10.1055/s-2005-921114
  12. Kaufman Z, Lew S, Griff el B, Dinbar A. Frozen-section diagnosis in surgical pathology. A prospective analysis of 526 frozen sections. Cancer 1986;57:377-379. https://doi.org/10.1002/1097-0142(19860115)57:2<377::AID-CNCR2820570231>3.0.CO;2-M
  13. Howanitz PJ, Hoff man GG, Zarbo RJ. Th e accuracy of frozensection diagnoses in 34 hospitals. Arch Pathol Lab Med 1990;114:355-359.

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