Discrepancy Between Endoscopic Forceps Biopsy And Endoscopic Submucosal Dissection In Esophageal Epithelial Neoplasia

Objective: To perform endoscopic submucosal dissection(ESD) for esophageal lesions which have been diagnosed as high-grade intraepithelial neoplasia by endoscopic forceps biopsy,and to comfirm the pathological nature after resection.To investigate the differences of histopathological diagnosis between the ESD specimens and the biopsy specimens.Methods:We collected and analysised all the 67 patients which were diagnosed as esophageal high-grade intraepithelial squamous neoplasia in biopsy specimens from April 2010 to December 2014.All of the patients underwent ESD, and resected specimens were reviewed microscopically in the first people’s hospital of Changzhou. According to the histologic results,the patients were divided into different groups.We compared some potential factors associated with the discrepancies,for example age,gender, drinking history,locations,length,specimen size and tumor morphology.Results:Compared with pathologic diagnosis after ESD,the yield of biopsy consisted of 44.78%(30/67) as consistent,46.27%(31/67) as underdiagnosed,and 8.96%(6/67) as overdiagnosed.Gender, locations, specimen size and type 0-Ⅱc were found by univariate analysis to be statistically significant factors predicting an upgraded histology after ESD(p<0.05).Conclusions: Underestimation in biopsies is in male and/or non-middle esophagus leisions and/or larger specimen and/or type 0-Ⅱc,ESD sample can provide objective diagnosis and provide the guideline for the further treatment.