Endoscopic predictors for undifferentiated histology in differentiated XXXX prior to endoscopic resection.

@entity1 @entity420 @entity356
BACKGROUND: There is often a discrepancy between results from endoscopic forceps biopsy and resected specimen. We aimed to identify endoscopic predictors for undifferentiated histology in differentiated @entity356 prior to endoscopic resection. METHODS: Medical records of the @entity1 who underwent endoscopic submucosal dissection (ESD) for biopsy-proven differentiated @entity356 at Seoul National University Hospital between July 2005 and July 2014 were retrospectively reviewed. The lesions were divided into two groups based on the final histologic result of ESD: differentiated @entity420 (DA group) and undifferentiated histology (UDH group). The discordant rate, clinicopathologic characteristics, and endoscopic factors were analyzed. RESULTS: A total of 1641 early @entity356 from 1615 @entity1 were included. Of these, 1556 (94.8  %) were diagnosed as DA and 85 (5.2  %) as UDH. The mean age was significantly lower, and number of @entity1 was higher in the UDH group than in the DA group. On multivariate analysis, age <65  years [odds ratio (OR) 1.75, 95  % confidence interval (CI) 1.10-2.80], female sex (OR 3.19, 95  % CI 2.00-5.08), endoscopic size >10  mm (OR 1.81, 95  % CI 1.12-2.92), depressed type (OR 2.85, 95  % CI 1.56-5.21), nodularity (OR 2.83, 95  % CI 1.59-5.05), and whitish discoloration (OR 19.64, 95  % CI 6.98-55.25) were independent predictors. CONCLUSIONS: Female sex, age <65  years, large endoscopic size, depressed morphology, surface nodularity, and whitish discoloration were predictors for UDH. Meticulous attention should be paid to the lesions with these endoscopic predictors for determining the risk of UDH prior to endoscopic resection.
