위암환자에서 수술 전 내시경생검조직검사와 수술 후 조직검사의 변동 (Pathologic Discrepancy between Endoscopic Biopsy and Resected Sepicimen in Gastric Adenocarcinoma)

서지정보

· 발행기관 : 고신대학교(의대) 고신대학교 의과대학 학술지
· 수록지 정보 : 고신대학교 의과대학 학술지 / 24권 / 2호 / 135 ~ 140페이지
· 저자명 : 서경원, 이상호

초록

the preoperative endoscopic biopsy and post operative resection.
s Methods :To analyse the factors affecting the discrepancy 280 cases, in 270 gastric adenocarcinoma patients who underwent surgical operation in this hospital since 1st August, 2004, to 31st July 2005, were subjected to present study.
Histologic types were categorized into well-differentiated tubular(WD-T), moderately-differentiated tubular(MD-T), poor-differentiated tubular(PD-T), signet ring cell carcinoma, and papillary adenocarcinoma(Pap). The data is gender, tumor marker, concordance of pathologist, tumor location, T and N factor, and stage in this study s Results : From the cases exhibiting WD-T, MD-T, PD-T, and SRC in endoscopic biopsy,52.9%, 60.4%,38.9% and 65.6%, respectively, showed the same pathology in resected specimen. The sensitivity was analysed as 70.3%, 52.9%, 26.9%, 80% respectively. For the statistically significant factors affecting the pathologic discrepancy, male patient showed higher discrepancy. In this cases, the discrepancy rate of gender is 49% in male, 34% in female patients with elevated CEA level had higher discrepancy. And that is statistically significant factors affecting the pathologic discrepancy.
However, Patients with elevated CA19-9 levels also showed higher discrepancy, but no significance. Also, There is no difference about discrepancy according to concordance of pathologists who reported histologic biopsy, in the preoperation and postoperation. When discrepancy was presented, 44.9% was reported in accord case, 44.2% was reported in discord case with respect to pathologist. As for the discrepancy following the location of tumor, data showed less discrepancy, in cases where tumor was located at the lower 1/3, but this showed no significance. In the change of pathologic results based on T,N factor, It showed no significance.but, it is noticeable in mucosal, submucosal cancer that was reported 32.2% and 57.4% present rate of discrepancy, patients with elevated stage had higher discrepancy, but this showed no significance.
s Conclusions : The statistically significantly factors that affected the pathologic discrepancy were gender, and rise in CEA level. Mucosal and submucosal cancer showed discrepancy in 32.5% and 57.4% respectively, and further study is thought to be necessary. Also, further retrospective study with more cases is thought be needed for early gastric adenocarcinoma.

영어초록

the preoperative endoscopic biopsy and post operative resection.
s Methods :To analyse the factors affecting the discrepancy 280 cases, in 270 gastric adenocarcinoma patients who underwent surgical operation in this hospital since 1st August, 2004, to 31st July 2005, were subjected to present study.
Histologic types were categorized into well-differentiated tubular(WD-T), moderately-differentiated tubular(MD-T), poor-differentiated tubular(PD-T), signet ring cell carcinoma, and papillary adenocarcinoma(Pap). The data is gender, tumor marker, concordance of pathologist, tumor location, T and N factor, and stage in this study s Results : From the cases exhibiting WD-T, MD-T, PD-T, and SRC in endoscopic biopsy,52.9%, 60.4%,38.9% and 65.6%, respectively, showed the same pathology in resected specimen. The sensitivity was analysed as 70.3%, 52.9%, 26.9%, 80% respectively. For the statistically significant factors affecting the pathologic discrepancy, male patient showed higher discrepancy. In this cases, the discrepancy rate of gender is 49% in male, 34% in female patients with elevated CEA level had higher discrepancy. And that is statistically significant factors affecting the pathologic discrepancy.
However, Patients with elevated CA19-9 levels also showed higher discrepancy, but no significance. Also, There is no difference about discrepancy according to concordance of pathologists who reported histologic biopsy, in the preoperation and postoperation. When discrepancy was presented, 44.9% was reported in accord case, 44.2% was reported in discord case with respect to pathologist. As for the discrepancy following the location of tumor, data showed less discrepancy, in cases where tumor was located at the lower 1/3, but this showed no significance. In the change of pathologic results based on T,N factor, It showed no significance.but, it is noticeable in mucosal, submucosal cancer that was reported 32.2% and 57.4% present rate of discrepancy, patients with elevated stage had higher discrepancy, but this showed no significance.
s Conclusions : The statistically significantly factors that affected the pathologic discrepancy were gender, and rise in CEA level. Mucosal and submucosal cancer showed discrepancy in 32.5% and 57.4% respectively, and further study is thought to be necessary. Also, further retrospective study with more cases is thought be needed for early gastric adenocarcinoma.

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