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Clinical interpretation of the histological typing of gastric cancer using endoscopic forceps biopsy
Yoshitaka Matsubara1, Hideo Yanai, Kimio Ishiguro
1Department of Gastroenterology and Hepatology, Yamaguchi University School of Medicine Ube, Japan.
Background/Aims:
Histological typing of gastric cancer is important for determining the treatment strategy and predicting the prognosis. We compared the histological types obtained by endoscopic forceps biopsy with the finally determined histological types of surgically resected specimens to investigate the reliability of histologically typing gastric cancer by biopsy.
Methodology:
Agreement between the biopsy typing and the final histological typing based on the predominant histology of the resected tumor was studied in 115 consecutive gastric cancers.
Results:
The overall agreement rate of histological typing of gastric cancer was 75.7%. In patients with early gastric cancer, the agreement rate was a high 82.5% and the final histological type was usually predicted. In patients with advanced gastric cancer, the agreement rate was 72.0%, which was significantly lower than for early gastric cancer (p<0.05). The agreement rate for advanced differentiated cancer was also significantly lower than that for early cancer (63.6% vs. 90.0%) (p<0.05).
Conclusions:
The reliability of using histological typing by biopsy to set the indications for endoscopic treatment and for preoperative prediction of the prognosis is expected to be good for differentiated early gastric cancer, but it might not be adequate for advanced cancer or undifferentiated cancer.
