Sangjeong Ahn, Do Youn Park1. 1. From the Department of Pathology, Pusan National University Hospital and Pusan National University School of Medicine, and the Biomedical Research Institute, Pusan National University Hospital, Pusan, Korea.
Abstract
CONTEXT: -The diagnosis of gastric epithelial lesions is difficult in clinical practice, even with the recent developments and advances in endoscopic modalities, owing to the diverse morphologic features of the lesions, lack of standardized diagnostic criteria, and the high intraobserver and interobserver variabilities in the nonneoplastic (regenerative)-neoplastic spectrum. OBJECTIVE: -To provide an overview of the current concepts and unresolved issues surrounding the diagnosis of diseases in the nonneoplastic-neoplastic spectrum, and to discuss some noteworthy properties and histologic features of gastric epithelial lesions. DATA SOURCES: -A comprehensive assessment of the medical literature on gastric epithelial lesions was performed; we also interjected our own experiences into the discussion. Sources included original studies, review articles, and textbooks related to the field. CONCLUSIONS: -Our literature review revealed that clear cell changes and micropapillary carcinoma components in gastric carcinomas are associated with poor clinical outcomes and should hence be included in pathologic reports. Moreover, we suggest a stepwise biopsy-endoscopic resection modality for the diagnosis of borderline neoplasia-nonneoplasia cases.
CONTEXT: -The diagnosis of gastric epithelial lesions is difficult in clinical practice, even with the recent developments and advances in endoscopic modalities, owing to the diverse morphologic features of the lesions, lack of standardized diagnostic criteria, and the high intraobserver and interobserver variabilities in the nonneoplastic (regenerative)-neoplastic spectrum. OBJECTIVE: -To provide an overview of the current concepts and unresolved issues surrounding the diagnosis of diseases in the nonneoplastic-neoplastic spectrum, and to discuss some noteworthy properties and histologic features of gastric epithelial lesions. DATA SOURCES: -A comprehensive assessment of the medical literature on gastric epithelial lesions was performed; we also interjected our own experiences into the discussion. Sources included original studies, review articles, and textbooks related to the field. CONCLUSIONS: -Our literature review revealed that clear cell changes and micropapillary carcinoma components in gastric carcinomas are associated with poor clinical outcomes and should hence be included in pathologic reports. Moreover, we suggest a stepwise biopsy-endoscopic resection modality for the diagnosis of borderline neoplasia-nonneoplasia cases.
Authors: Joon Mee Kim; Jin Hee Sohn; Mee-Yon Cho; Woo Ho Kim; Hee Kyung Chang; Eun Sun Jung; Myeong-Cherl Kook; So-Young Jin; Yang Seok Chae; Young Soo Park; Mi Seon Kang; Hyunki Kim; Jae Hyuk Lee; Do Youn Park; Kyoung Mee Kim; Hoguen Kim; Young Ju Suh; Sang Yong Seol; Hwoon-Yong Jung; Deuck-Hwa Kim; Na Rae Lee; Seung-Hee Park; Ji Hye You Journal: Cancer Res Treat Date: 2019-04-01 Impact factor: 4.679