The following is the summary of “Histopathologic Diagnosis Discrepancies Between Preoperative Endoscopic Forceps Biopsies and Specimens Resected by Endoscopic Submucosal Dissection in Superficial Gastric Neoplasms” published in the January 2023 issue of Clinical gastroenterology by Ramos, et al.

Procedures involving endoscopic forceps biopsy (EFB) are the gold standard for obtaining tissue samples from superficial lesions found during upper gastrointestinal endoscopy. The histopathology report determines the next step in care. Early gastrointestinal neoplasms can be removed in one surgical procedure with the use of endoscopic submucosal dissection (ESD), which also gives a sufficient specimen for a more accurate histopathologic evaluation. The purpose of this research was to quantify the frequency with which EFB and specimens removed by ESD differ histopathologically and to identify the factors that increase the likelihood of such difference.

This is a retrospective analysis of patients who had EFB followed by ESD for superficial gastric neoplasms. Based on the histopathologic findings of EFB and ESD specimens, we classified patients as concordant or discordant. Furthermore, researchers investigated the link between histopathologically inconsistent adenocarcinoma samples and deeper-lying neoplastic invasion, as well as the factors that may have contributed to the occurrence of histopathologic discordance. The end result is that 84 individuals were included in the final tally of 115 stomach ESD treatments conducted. 

In 35.6 % of instances (30/84 lesions), there was a histopathologic discrepancy between EFB and ESD tissues. Histologic inconsistency was found to have a significant relationship to lesion size (P=0.028) in both univariate and multivariate analyses. About one-third of cases may have histopathologic differences between EFB and ESD specimens, especially for lesions exceeding 20 mm, which may cause important delays in the exact diagnosis and treatment of stomach cancer.