Study On The Consistency Between Pathological Diagnosis Of High-grade Intraepithelial Neoplasia By Esophageal Mucosal Biopsy And Pathological Diagnosisafter Operation

BackgroundIn recent years,with the development of digestive endoscopy technology,the development of various instruments and equipment and the standardization of endoscopy operation,the diagnostic rate of early esophageal tumors has been significantly improved.In recent years,the gold standard for diagnosis of esophageal cancer in China is endoscopic biopsy pathology.However,many studies at home and abroad show that there are obvious differences between endoscopic biopsy and post-operative pathology,but there is no unified conclusion on the relevant factors of biopsy and post-operative pathology.ObjectiveBy comparing the pathological diagnosis of high-grade intraepithelial neoplasia(HGIN)by esophageal mucosal biopsy with that after ESD,the consistency of preoperative biopsy and post-operative pathology of HGIN and its influencing factors were discussed,and a more scientific and reasonable method was found to increase the pathological diagnosis rate of biopsy.Materials and methodsThis study retrospectively analyzed the clinical data of patients with HGIN diagnosed by endoscopic biopsy in Liaocheng People’s Hospital from December 2015 to December2018.There were 132 patients and 139 lesions.The consistency between preoperative biopsy pathology and postoperative pathology was analyzed.According to the consistency of preoperative pathology and preoperative biopsy pathology,the subjects were divided into consistent group and inconsistent group.Relevant factors of inconsistent pathological diagnosis.Results(1)A total of 132 patients with esophageal high-grade intraepithelial neoplasia met the inclusion criteria,including 89 males and 43 females,125 patients with only one lesion,7patients with two lesions simultaneously removed,a total of 139 lesions.Among all the patients,the oldest age was 72 years old and the youngest was 39 years old.The average age was(55.48±7.78).The oldest age was 72 years old and the youngest was 39 years old for males,with the oldest was 68 years old and the youngest was 43 years old for females.(2)The coincidence rate between preoperative biopsy and pathological diagnosis after ESD was 70.50%(98/139).There were 27.34%(38/139)upgraded to esophageal cancer and 2.16%(3/139)reduced to low-grade intraepithelial neoplasia.(3)multiple factor analysisMultivariate logistic regression analysis showed that surface erythema(P=0.005,OR=3.931),nodular lesions(P=0.001,OR=5.386),maximum diameter of lesions≥2 cm(P=0.028,OR=2.852),circumference of lesions≥1/2 round(P=0.039,OR=2.658),slightly depressed-type(P=0.009,OR=6.127)were independent risk factors affecting pathological inconsistency between preoperative biopsy and post-operative pathology.ConclusionsEndoscopic biopsy for the diagnosis of high-grade intraepithelial neoplasia is different from pathology after ESD,which needs to be dealt with pertinently.The main risk factors for pathological inconsistencies before and after surgery were surface erythema,nodular lesions,maximum diameter of lesions≥2 cm,circumference of lesions≥1/2 round,and slightly depressed-type lesions.