Potential factors predicting histopathologically upgrade discrepancies between endoscopic forceps biopsy of the colorectal low-grade intraepithelial neoplasia and endoscopic resection specimens

作者：Youxiang Chen, Junbo Hong, Yining Wang, Jiangshan Deng, Miao Qi, Wei Zuo, Yuanzheng Hao, Anjiang Wang, Yi Tu, Shan Xu, Xiaodong Zhou, Xiaojiang Zhou, Guohua Li, Liang Zhu, Xu Shu, Yin Zhu, Nonghua Lv · 发表于：Research Square · 年份：2022 · DOI：10.21203/rs.3.rs-1398226/v1 · 被引用次数：1 · 研究领域：Colorectal Cancer Screening and Detection、Gastric Cancer Management and Outcomes、Genetic factors in colorectal cancer

Abstract Background: It was gradually accepted that endoscopic fragment biopsy (EFB) diagnosis cannot accurately guarantee the absence of higher-grade neoplasms within the lesion of digestive tract. There are no well-established predictors for histopathologically upgrade discrepancies between EFB diagnosing colorectal low-grade intraepithelial neoplasia (LGIN) and endoscopic resection (ER) specimens demonstrating higher-grade diseases. Methods: A total of 918 colorectal LGINs was histopathologically diagnosed by EFB, including 162 cases with histopathologically upgrade discrepancy and 756 concordant cases. We compared clinicopathological data and relevant pathologic results of EFB and ER specimen between these two groups. Multivariate analysis was performed to investigate predictors for this upgrade histopathology. Results: The predominant upgrade discrepancy of LGINs diagnosed by EFB was upgrades to high-grade dysplasia (n = 114, 70.4%), followed by upgrades to intramucosal carcinoma (n = 33, 20.3%), submucosal adenocarcinoma (n = 10, 6.2%) and advanced adenocarcinoma (n = 5, 3.1%). NSAID history (OR 4.83; 95 % CI, 2.27-10.27; P < 0.001), lack of standardization of EFB number (OR 2.99; 95 % CI, 1.91-4.68; P < 0.001), ≥ 1.0 cm maximum diameter of the target adenoma (OR 6.18; 95% CI, 1.32-28.99; P = 0.021), lobulated shape (OR 2.68; 95 % CI, 1.65-4.36; P < 0.001), erythema (OR 2.42; 95 % CI, 1.50-3.91; P < 0.001), erosion (OR 7.12; 95 % CI, 3.91-12.94; P < 0.001...