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首页> 外文期刊>Modern Pathology >Endoscopic mucosal resection for gastric epithelial neoplasms: a study of 39 cases with emphasis on the evaluation of specimens and recommendations for optimal pathologic analysis
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Endoscopic mucosal resection for gastric epithelial neoplasms: a study of 39 cases with emphasis on the evaluation of specimens and recommendations for optimal pathologic analysis

机译：胃镜上皮瘤内镜黏膜切除术：研究39例，侧重于标本评估和最佳病理分析建议

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摘要

Endoscopic mucosal resection of gastric neoplasms is a curative technique that avoids surgery and its potential complications. Infrequently performed in the West, the limitations, pitfalls and challenges provided by this new therapeutic modality are not well known by general surgical pathologists. We evaluated a series of 39 endoscopic mucosal resections and assessed the correlation between original biopsies and final diagnoses, depth of excision, status of deep and lateral margins, artifactual changes and recurrence rate. The tumors consisted of 24 intramucosal carcinomas, six high-grade dysplasias, eight low-grade dysplasias and one submucosal invasive carcinoma. The preresection diagnoses corresponded to the final evaluation in 63% of the cases with previous biopsies. In 37% of the cases, the biopsies under-diagnosed the neoplasia. The rate of positive margins was 38%. Iatrogenic changes, that is, intramucosal hemorrhage and electrodiathermic burn, were noted in 44% of the cases but hindered the pathologic evaluation in only 10% of the cases. Persistence or recurrence was observed in only seven cases and there was no progression to advanced adenocarcinoma. Based on our experience, we offer some recommendations in order to provide optimal pathologic analysis of endoscopic mucosal resection specimens.
机译：胃肿瘤的内镜黏膜切除术是一种可避免手术及其潜在并发症的治愈性技术。在西方国家，这种手术方式很少进行，这种新的治疗方式所带来的局限性，陷阱和挑战并不为普通外科病理学家所熟知。我们评估了39例内镜下黏膜切除术，评估了原始活检和最终诊断，切除深度，深部和外侧切缘的状态，人为变化和复发率之间的相关性。肿瘤由24个粘膜内癌，6个高度不典型增生，8个低度不典型增生和1个粘膜下浸润癌组成。切除前的诊断与先前活检中63％的病例的最终评估相符。在37％的病例中，活检未充分诊断出肿瘤。正边际利润率为38％。在44％的病例中发现了医源性变化，即粘膜内出血和电渗热烧伤，但只有10％的病例阻碍了病理评估。仅7例观察到持续性或复发，并且没有进展为晚期腺癌。根据我们的经验，我们提供一些建议，以便为内镜黏膜切除标本提供最佳的病理分析。

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