Diagnostic Yield of Gastroscopic Biopsy in Advanced Gastric Cancer

Original Article

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2009;9(1):47-51.
Published online July 10, 2009.

진행 위암에서 조직생검 부위에 따른 내시경 진단율

안재홍ㆍ김승영ㆍ김진남ㆍ박선민ㆍ김동일ㆍ정성우ㆍ구자설ㆍ박종재ㆍ전훈재ㆍ이홍식ㆍ최재현ㆍ이상우

고려대학교 의과대학 내과학교실, 소화기연구소

Abstract

Background/Aims
To evaluate diagnostic yield of gastroscopic biopsy of advanced gastric cancer (AGC) according to tumor location, biopsy site, endoscope and endoscopist. Methods: A prospective study was carried out in 103 AGC patients. We obtained gastroscopic biopsies at the inner, top, outer margin, base and tumor island in ulcerative type cancers and random biopsies in the Borrmann type 1 and 4 cancers. Results: The positive rate of gastroscopic biopsy was good at inner, top margin and base in the antrum and body. At the angle, positive rate of inner margin and base were higher than other sites. According to the experience of endoscopist, positive rate of Borrmann type 3 cancer by experts was 95.9%, compared with 92.6% of non-experts. However, same results were showed in the Borrmann type 1, 2, and 4 cancers between the two groups. Conclusions: For improving diagnostic yield of gastroscopic biopsy for histologic confirmation of AGC, it should be started at the top margin which is easy to approach. At least, three biopsies at the top, inner margin and base are necessary for the diagnosis of AGC. (The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2009;9:47-51)

Key Words: Diagnosis, Gastroscopic biopsy, Advanced gastric cancer