scholarly journals Endoscopic resections for superficial esophageal squamous cell epithelial neoplasia: focus on histological discrepancies between biopsy and resected specimens

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lang Yang ◽  
Hua Jin ◽  
Xiao-li Xie ◽  
Yang-tian Cao ◽  
Zhen-hua Liu ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Squamous Cell ◽  
Medical Records ◽  
Intraepithelial Neoplasia ◽  
Lesion Size ◽  
Clinicopathological Parameters ◽  
Low Grade ◽  
Type B ◽  
Forceps Biopsy ◽  
Discrepancy Rate

Abstract Background Endoscopic resection has been used for high-grade intraepithelial neoplasia (HGIN) and superficial esophageal squamous cell carcinoma (ESCC) with limited risk of lymph node metastasis. However, some of these lesions cannot be accurately diagnosed based on forceps biopsy prior to treatment. In this study we aimed to investigate how to solve this histological discrepancy and avoid over- and under-treatment. Methods The medical records of patients with superficial esophageal squamous cell neoplasia who underwent endoscopic resection at our hospital from January 2012 to December 2019 were reviewed retrospectively. The histological discrepancy between the biopsy and resected specimens was calculated and its association with clinicopathological parameters was analyzed. Results A total of 137 lesions from 129 patients were included. The discrepancy rate between forceps biopsy and resected specimens was 45.3% (62/137). Histological discrepancy was associated with the histological category of the biopsy (p < 0.001). In addition, 17 of the 30 (56.7%) biopsies that was diagnosed as indefinite/negative for neoplasia or low-grade intraepithelial neoplasia were upgraded to HGIN or ESCC after resection. The upgrade was due to lesion size ≥ 10 mm (p = 0.002) and type B intrapapillary capillary loops (p < 0.001). Moreover, 34 of the 83 biopsies that were diagnosed with HGIN were upgraded to ESCC after resection, which was related to lesion size (p = 0.001), location (p = 0.018), and pink color sign (p = 0.002). Conclusions Histological discrepancy between forceps biopsy and resected specimens is common in clinical practice. Recognizing the risk factors for each histological category of biopsy may reduce these discrepancies and improve clinical management.

scholarly journals Combination of Endoscopic Resection and Radiofrequency Ablation for the Treatment of Esophageal Squamous Cell Neoplasia With Multiple Lugol-Voiding Lesions

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhihao Chen ◽  
Lizhou Dou ◽  
Yong Liu ◽  
Yueming Zhang ◽  
Shun He ◽  
...  
Keyword(s):  
Radiofrequency Ablation ◽  
Local Recurrence ◽  
Endoscopic Resection ◽  
Squamous Cell ◽  
Medical Records ◽  
Combined Treatment ◽  
Complete Response ◽  
Esophageal Mucosa ◽  
Treatment Area ◽  
Combination Treatments

BackgroundLocal recurrence of esophageal squamous cell neoplasia (ESCN) and metachronous ESCN was associated with severe background esophageal multiple Lugol-voiding lesions (LVLs) even though the primary early ESCNs were treated with endoscopic resection (ER). The aim of this study is to explore the feasibility and effectiveness of combination treatments of ER and radiofrequency ablation (RFA) in patients with early ESCNs with synchronous multiple LVLs.MethodsA total of 329 patients with early ESCNs and synchronous multiple LVLs received ER combined with RFA from September 2010 to September 2020. Clinical and pathological features and treatment outcomes were retrospectively reviewed using medical records. Factors associated with background esophageal multiple LVLs before combined treatment were analyzed.ResultsThe proportion of complete response (CR) was 96.7% after primary RFA, while 90.3% patients achieved CR for the last endoscopic examinations regardless if inside or outside the treatment area (TA). Degeneration of background esophageal multiple LVLs occurred in 70.2% of patients. The grade of background esophageal multiple LVLs before combined treatment was closely related to gender, smoking, and drinking. The incidence of metachronous ESCNs outside the TA of ER and local recurrence in the TA of ER was 3.9% and 1.2%, respectively.ConclusionsProphylactic RFA treatment of multiple LVLs together with ER treatment of the primary ESCNs may be effective in reducing the incidence of metachronous ESCNs and local recurrence through improving the background esophageal mucosa.

Is Lesion Size an Independent Indication for Endoscopic Resection of Biopsy-Proven Low-Grade Gastric Dysplasia?

2013 ◽  
Vol 59 (2) ◽  
pp. 428-435 ◽  
Author(s):  
Min Kyung Kim ◽  
Jae Young Jang ◽  
Jung-Wook Kim ◽  
Jae-Jun Shim ◽  
Chang Kyun Lee ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Lesion Size ◽  
Low Grade ◽  
Gastric Dysplasia

scholarly journals Immunohistochemical expression of p16INK4A in the lesions of uterine cervix

2020 ◽  
Vol 7 (10) ◽  
pp. A502-508
Author(s):  
Niharika Rawat ◽  
Shivapriya Rajan
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
High Grade ◽  
Cervical Lesions ◽  
Cancer Management ◽  
Squamous Intraepithelial Neoplasia

Background: Cervical cancer is the major cause of cancer deaths among women. Globally, around 5,70,000 new cases of cervical cancer and 3,11,000 deaths occurred in the year 2018. In India, Cervical cancer is a leading cause of cancer related mortality among women and the number of deaths is 60,000 per year among 97,000 diagnosed patients, especially those from lower socioeconomic group. Human Papilloma Virus (HPV) plays a crucial role in causing cervical dysplasia. This is done by upregulating p16INK4A, a cyclin dependent kinase inhibitor through interaction with cellular regulatory proteins. Hence p16INK4A can be used as a biomarker, since it is directly related variable for the presence of HPV. This study was conducted to evaluate the expression of p16INK4A in benign, premalignant and malignant cervical lesions and to assess its utility in diagnosing and grading cervical lesions. Methods: A total of 80 cervical specimens categorized histopathologically into nonspecific cervicitis, low grade squamous intraepithelial neoplasia (LSIL), high grade squamous intraepithelial neoplasia (HSIL) and squamous cell carcinoma cervix were included in this prospective study of one-year duration. Immunohistochemical study of p16INK4A were interpreted qualitatively and semi-quantitatively by Allred scoring system (0 to 8 points) which measures the proportion of stained cells and intensity of staining of cells. The collected data were statistically analyzed by ANOVA and chi square test. Result: Qualitative method showed absence of p16INK4A expression in all nonspecific cervicitis. 16.7% (2/12) LSIL, 100% (12/12) HSIL and 100% (28/28) squamous cell carcinoma cases showed p16INK4A positivity. Allred scoring of p16INK4A showed 66% (8/12) HSIL and 85.7% (24/28) squamous cell carcinoma cases with score 3 positivity. Hence high-grade lesions showed higher expression of this marker. Conclusion: IHC expression of p16INK4A showed increasing degree of expression from benign to premalignant and malignant lesions suggesting its diagnostic and prognostic value in the cervical cancer management

scholarly journals The diagnostic accuracy of conventional forceps biopsy compared to ESD

Open Medicine ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. 261-265
Author(s):  
Shimin Wu ◽  
Xinjian Zhu ◽  
Lijuan Xiang ◽  
Jianqiang Chen ◽  
Chunxiao Chen
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Submucosal Dissection ◽  
Active Treatment ◽  
Intraepithelial Neoplasia ◽  
Endoscopic Biopsy ◽  
Low Grade ◽  
High Grade ◽  
Forceps Biopsy ◽  
Gastric Epithelial Neoplasia ◽  
Treatment Measures

AbstractObjectiveconventional forceps biopsy (CFB) is the most popular way to screen for gastric epithelial neoplasia (GEN). Our study aimed to compare the diagnostic accuracy between conventional forceps biopsy and endoscopic submucosal dissection (ESD).Methods105 patients diagnosed GEN finally undertook ESD in our hospital were enrolled. We retrospectively assessed the characteristics of pathological results of CFB and ESD.ResultsThe overall pathologic concordance rate between the CFB and ESD specimens was 68.57%. 55 cases of CFB maintained low-grade intraepithelial neoplasia (LGIN) under ESD,18 cases (23.1%) diagnosis for high-grade intraepithelial neoplasia (HGIN), 5 cases (6.4%) diagnosis for cancer. Moreover, 10 cases of CFB maintained HGIN under ESD. Lesions with surface hyperemia (44.4% vs. 27.54%) or surface ulcer (57.14% vs.26.76%) were more likely to cancerate (P<0.05).Conclusionendoscopic biopsy in the diagnosis of low-grade intraepithelial neoplasia, may exist or progression to high-grade intraepithelial neoplasia, some may have cancer, should take active treatment measures.

scholarly journals Feasibility of Endoscopic Resection for Sessile Nonampullary Duodenal Tumors: A Multicenter Retrospective Study

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Sung Min Park ◽  
Joo Ho Ham ◽  
Byung-Wook Kim ◽  
Joon Sung Kim ◽  
Chang Whan Kim ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Medical Records ◽  
Complete Resection ◽  
Low Grade ◽  
High Grade ◽  
En Bloc ◽  
Endoscopic Intervention ◽  
Catholic University ◽  
Related Mortality ◽  
Demographic Features

Objectives. Sessile nonampullary duodenal tumors (SNADTs) are relatively rare and endoscopic resection of these lesions is considered more challenging than in other parts of the gastrointestinal tract. The aim of this study was to evaluate the feasibility of endoscopic resection for SNADT.Methods. Medical records including endoscopic resection for SNADT from July 2002 to July 2013 from 5 centers affiliated to The Catholic University of Korea were reviewed retrospectively. Demographic features and clinical outcomes such as complete resection and complications were analyzed.Results. A total of 56 lesions from 54 patients were enrolled in this study. Forty-five lesions were resected by endoscopic mucosal resection (EMR), 6 lesions by endoscopic submucosal dissection (ESD), and 5 lesions by simple polypectomy. Histologic examination after endoscopic resection revealed adenocarcinoma in 2, low grade adenoma in 25, high grade adenoma in 11, and carcinoid tumor in 18 lesions.En blocresection rates and histological complete resection rates were 78.6% (44/56) and 80.0% (28/35), respectively. Bleeding which required additional endoscopic intervention occurred in 1.8% (1/56) and perforation in 7.1% (4/56). There was no procedure-related mortality.Conclusions. Endoscopic resection techniques including ESD might be safe and effective modalities for the management of SNADT.

scholarly journals Abnormal Pap Smear Results in Outpatient Attendees in a Tertiary Care Center in Kathmandu, Nepal

2017 ◽  
Vol 16 (1) ◽  
pp. 3-7
Author(s):  
Ratna Adhikari Khatri ◽  
Lee Budhathoki ◽  
Arya Rana Pande ◽  
Sadikshya Singh
Keyword(s):  
Epithelial Cell ◽  
Squamous Cell ◽  
Pap Smear ◽  
Care Center ◽  
Tertiary Care ◽  
Pap Test ◽  
Intraepithelial Neoplasia ◽  
Low Grade ◽  
Squamous Intraepithelial Lesions ◽  
Intraepithelial Lesions

Introduction: Cervical cancer is one of the most common cancers in the world. It is the most common cancer among females in Nepal. Progression of pre-invasive precursor lesions called Cervical Intraepithelial Neoplasia (CIN) can result in invasive cancer over years and decades. Papanicolaou smear can detect these lesions early. The aim of this paper is to study the prevalence of abnormal Pap smear test and report the results.Methods: Observational study of Pap smear of 1100 women of age 21 to 65 years attending Gynaecological outpatient department of our hospital over a period of one year.Results: Pap smear results were recorded as per Bethesda system. 35% of smears had epithelial cell abnormality with 62.82% normal smear and 2.13%infections, bacterial vaginosis (1.94%) being most common. The highest epithelial cell abnormality was Low grade squamous intraepithelial lesions (29.90%) followed by Atypical squamous cell of undetermined significance (3.2%). High grade squamous intraepithelial lesions and carcinoma were next to follow (0.97% each). 80% of cancers were Squamous cell carcinoma.Conclusion: Premalignant and malignant lesions were found to be common in cervix. Pap test is simple, quick and effective way of screening them. Screening should be done at least once for all woman after the age of 30 as benefit is maximum in this age group.

scholarly journals Upgrade of Lesions Initially Diagnosed as Low-Grade Gastric Dysplasia upon Forceps Biopsy Following Endoscopic Resection

Gut and Liver ◽  
2011 ◽  
Vol 5 (2) ◽  
pp. 187-193 ◽  
Author(s):  
Chan Sik Won ◽  
Mee Yon Cho ◽  
Hyun Soo Kim ◽  
Hye Jeong Kim ◽  
Ki Tae Suk ◽  
...  
Keyword(s):  
Endoscopic Resection ◽  
Low Grade ◽  
Forceps Biopsy ◽  
Gastric Dysplasia

207 ESOPHAGEAL BIOPSY AND SWAB MICROBIAL CHARACTERIZATION WITH HEALTH AND ESOPHAGEAL DISEASE IN CHINA

2020 ◽  
Vol 33 (Supplement_1) ◽  
Author(s):  
M Li ◽  
D Shao ◽  
G Song ◽  
F Meng ◽  
C Hao ◽  
...  
Keyword(s):  
Squamous Cell ◽  
Beta Diversity ◽  
Precancerous Lesions ◽  
Intraepithelial Neoplasia ◽  
Esophageal Disease ◽  
Rrna Gene ◽  
Low Grade ◽  
Microbial Composition ◽  
Esophageal Biopsy ◽  
Unifrac Distance

Abstract   Little is known about the esophageal microbiota and esophageal health or disease in China, especially esophageal squamous cell precancerous lesions. And there is currently no optimal sampling method for esophageal microbiota. Consequently, we compared microbial signature between and within esophageal biopsy and swab specimens from participants in healthy or with esophageal diseases. Methods A total of 236 subjects were recruited in the Linxian Cancer Hospital (Henan, China), including 5 groups as 70 healthy cases, 70 esophagitis cases, 70 low grade intraepithelial neoplasia (LGIN) cases, 19 high grade intraepithelial neoplasia (HGIN) cases and 7 esophageal squamous cell carcinoma (ESCC) cases. Sterile biopsies and swabs were used to collect paired samples from the same participants under the endoscopy examination. DNA was extracted with the MoBio PowerSoil Kit. Data from 16S rRNA gene sequencing were processed using QIIME2 and R to evaluate differences in alpha and beta diversity and taxonomic relative abundances. Results Alpha diversity was not significantly different between specimens (biopsy = 116.2, swab = 118.0, P &gt; 0.05). In swabs, there were differences of observed OTUs among groups but not Shannon index, detailly, there was an inconspicuous decreasing from Health (125.0) to ESCC (114.0). About beta diversity, no distinct clustering by specimen was observed for weighted Unifrac distance and unweighted Unifrac distance. The 10 dominant genera were similar between specimens and among groups. Specially, Streptococcus was the most abundant except ESCCs; Fusobacterium was in the top ten only in ESCCs. And there was a decreasing of Prevotella 7 and an increasing of Haemophilus as progression. Conclusion Esophageal biopsy and swab specimens could yield similar bacterial composition. Both can be used to find clues of microbiota and disease. And esophageal microbial composition and progression characterizations could provide new idea and basis for large scale, prospective cohort studies in the future.

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