ADVERTISEMENT
Discriminating factors for gastric neoplasm among regenerative atypia found in screening upper gastrointestinal endoscopy
Background
In screening endoscopy, biopsies for suspicious malignant lesions often show a diagnosis of regenerative atypia which makes it difficult to make clinical decisions because of ambiguous pathologic characteristics. Therefore, we performed analysis to find discriminating factors for true gastric neoplasms among regenerative atypia found in screening endoscopy.
Methods
We reviewed medical records and endoscopic findings of individuals with regenerative atypia found in forcep biopsies performed in screening upper gastrointestinal endoscopy between October 2003 and December 2017.
Results
A total of 577 individuals had follow-up endoscopic biopsy for regenerative atypia. Among them, 11 were found to have adenoma (1.9%), 20 early gastric cancer (3.5%), and 1 MALToma (0.2%). There was no one with advanced gastric cancer. Most of the lesions were small erosions (n = 424, 73.5%). In multivariable analysis, whitish discoloration (OR, 6.545; 95% CI, 1.413 - 30.309, p = 0.016) and age (OR, 1.078; 9% CI, 1.038 – 1.120; p<0.001) were found to be independent risk factors for neoplasm, while ulcer scar and spontaneous bleeding were not.
Conclusions
Short-term follow-up and repeated endoscopic biopsy should be considered for regenerative atypia found in screening endoscopy, especially among elderly with whitish discoloration. Also, immunostaining should be considered for such lesions.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosures
All authors have declared no conflicts of interest.
