[Histologic discrepancy between gastric biopsy and resection specimen in the era of endoscopic treatment for early gastric cancer].

Endoscopic resection (ER) is accepted as a treatment option for early gastric cancer in patients with negligible risk of lymph node metastasis. Determination of histologic differentiation of adenocarcinoma based on pretreatment endoscopic biopsy is critical in deciding the treatment strategy of ER versus surgical resection. However, discrepancies are frequent between pretreatment biopsies and ER specimens, which may result in an additional gastrectomy after ER. In this context, a review on possible factors contributing to the diagnostic discrepancy in the histologic difference between the pretreatment biopsy and ER is necessary. Two major factors are significantly associated with this discrepancy: pathologic characteristics of the tumor itself, i.e. histologic heterogeneity (tumor factor), and diagnostic procedure performed by endoscopists or pathologists (human factor). In this review, we focus on pathologic report of pretreatment biopsy specimens and its clinical significance.