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The Study of Pathologic Difference between Endoscopic Biopsy before EMR and Histology of Specimen after Endoscopic Mucosal Resection (EMR) on Gastric Flat Adenoma or Early Gastric Cancer (EGC)

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¹ÚÇü±Ù ( Park Hyeong-Keun ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç

õ¿µ±¹ ( Cheon Young Koog ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
Á¤Àμ· ( Jung In-Seop ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
±èÁø¿À ( Kim Jin-Oh ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
Á¶ÁÖ¿µ ( Cho Joo-Young ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
Á¤Çö±¸ ( Jung Hyun-Ku ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
Áø¼Ò¿µ ( Jin So-Young ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ÀÓ»óº´¸®Çб³½Ç
½ÉÂù¼· ( Shim Chan-Sup ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç ¡¤ ¼ÒÈ­±â¿¬±¸¼Ò
ÀÌÁؼº ( Lee Joon-Seong ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
¹ÚÇöÁØ (  ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç
õ°©Áø ( Cheon Gab-Jin ) - ¼øÃµÇâ´ëÇб³ Àǰú´ëÇÐ ³»°úÇб³½Ç

Abstract

¸ñÀû: ³»½Ã°æÀû »ý°Ë°á°ú¿Í ¿Ü°úÀûÀ¸·Î Á¦°ÅÇÑ Á¶Á÷°úÀÇ ÇØºÎº´¸®ÇÐÀûÀÎ ¼Ò°ßÀÇ Â÷ÀÌ´Â 7~15% Á¤µµÀÎ °ÍÀ¸·Î º¸°íÇϰí ÀÖ´Ù. ÀÌ¿¡ ÀúÀÚ µîÀº ³»½Ã°æÀû Á¡¸·ÀýÁ¦¼úÀ» ½ÃÇà ¹ÞÀº °æ¿ì¿¡¼­ ³»½Ã°æÀû »ý°Ë¼Ò°ß°ú Á¡¸·ÀýÁ¦¼ú¿¡ ÀÇÇØ ¾ò¾îÁø Á¶Á÷°úÀÇ ÇØºÎº´¸®ÇÐÀûÀÎ Â÷À̸¦ ºñ±³ ºÐ¼®ÇÏ¿© º¸°íÀÚ ÇÏ¿´´Ù.

´ë»ó ¹× ¹æ¹ý: À§ ÆíÆò¼±Á¾ ȤÀº Á¶±âÀ§¾ÏÀ¸·Î Áø´ÜµÇ¾î EMRÀ» ½ÃÇàÇÑ 145¸í Áß¿¡ EMR Àü »ý°Ë°ú EMR ÈÄÀÇ ÀýÁ¦Á¶Á÷À» ºñ±³ÇÒ ¼ö ÀÖ¾ú´ø 36¿¹¸¦ ´ë»óÀ¸·Î ºñ±³ ºÐ¼®ÇÏ¿´°í 1¸íÀÇ º´¸®ÇÐÀÚ°¡ ºñ±³ÇÏ¿´´Ù.

°á°ú: 1) ´ë»óȯÀÚ 36¿¹ Áß Á¶±âÀ§¾ÏÀº 13¿¹, À§ ÆíÆò¼±Á¾ÀÌ 23¿¹·Î¼­ Á¶±âÀ§¾Ï Áß ÇØºÎº´¸®ÇÐÀû Â÷À̰¡ ÀÖ¾ú´ø °æ¿ì´Â 2¿¹(15.4%)À̾ú°í, À§ ÆíÆò¼±Á¾Àº 23¿¹ Áß 11¿¹¿¡¼­ Â÷À̰¡ ÀÖ¾ú´Ù. 2) »ý°Ë¿¡¼­ °íºÐÈ­¼±¾ÏÁ¾¼Ò°ßÀÎ Á¶±âÀ§¾Ï¿¡¼­ Â÷À̸¦ º¸ÀÎ 2¿¹´Â EMR ÈÄ °¢°¢ ÁߵÀÇ ¼±¾ÏÁ¾ ¼Ò°ß°ú °íÀÌÇü¼ºÁõÀ» µ¿¹ÝÇÑ ¼±Á¾ÀÇ ¼Ò°ßÀ̾ú´Ù. 3) À§ ÆíÆò¼±Á¾ 23¿¹ Áß ³»½Ã°æÀû »ý°Ë°ú ³»½Ã°æÀû Á¡¸· ÀýÁ¦¼ú ÈÄÀÇ Á¶Á÷¼Ò°ßÀÇ Â÷À̸¦ º¸ÀÎ ¿¹´Â 11¿¹·Î¼­ 47.8%À̾ú´Ù.

°á·Ð: Á¶±âÀ§¾Ï°ú À§ ÆíÆò¼±Á¾¿¡¼­ ³»½Ã°æÀû »ý°Ë°ú ³»½Ã°æÀû Á¡¸·ÀýÁ¦¼ú ÈÄÀÇ ÀýÁ¦µÈ Á¶Á÷ »çÀÌÀÇ Á¶Á÷¼Ò°ßÀÇ Â÷ÀÌ´Â °¢°¢ 15.4%, 47.8%¿´´Ù.

Background/Aims: It is not uncommon to show discrepancy between the histology of the endoscopic biopsy and that of the resected specimen obtained from the same lesion by EMR. The aim of this study was to ascertain whether routine endoscopic biopsy specimens are sufficient to qualify the representative enough to reliable indication of EMR.

Methods: We retrospectively reviewed 36 cases that could be compared the histologic results from the resected specimens by EMR to the tissue obtained by endoscopic biopsy. The histologic slides were reviewed by one pathologist.

Results: Of the 36 cases, 13 cases of EGC and 23 cases of gastric flat adenomas were included. Among 13 cases of EGC, 2 case (15.4%) revealed discrepancy between the histology of the endoscopic biopsy and that of a resected specimen by EMR. The
histology of a resected specimen by EMR revealed moderate differentiated adenocarcinoma, while that of endoscopic biopsy was a well differentiated adenocarcinoma. Gastric flat adenoma revealed 47.8% (11/23) of discrepancy.

Conclusions: The histologic discrepancy between the result of endoscopic biopsy and that of the resected specimen obtained by EMR was about 8% in EGC and 47.8% in gastric flat adenoma.

Ű¿öµå

Á¶±âÀ§¾Ï; À§ ÆíÆò¼±Á¾;³»½Ã°æÀû Á¡¸·ÀýÁ¦¼ú;ÇØºÎº´¸®ÇÐÀû Â÷ÀÌ;
Early gastric cancer;Gastric flat adenoma;EMR;Histologic discrepancy;
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