Potential Factors Predicting Histopathologically Upgrade Discrepancies between Endoscopic Forceps Biopsy of the Colorectal Low‐Grade Intraepithelial Neoplasia and Endoscopic Resection Specimens

作者：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, Youxiang Chen · 发表于：BioMed Research International · 年份：2022 · DOI：10.1155/2022/1915458 · 被引用次数：4 · 研究领域：Esophageal Cancer Research and Treatment、Gastric Cancer Management and Outcomes、Colorectal Cancer Screening and Detection

Background . It was gradually accepted that endoscopic fragment biopsy (EFB) diagnosis cannot accurately guarantee the absence of higher‐grade neoplasms within the lesion of the 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. Methods . A total of 918 colorectal LGINs was histopathologically diagnosed by EFB, including 162 cases with upgrade discrepancy and 756 concordant cases. We compared clinicopathological data of EFB and ER specimens between these two groups. Multivariate analysis was performed to identify predictors for this upgrade histopathology. Results . The predominant upgrade discrepancy of LGINs diagnosed by EFB was upgrades to high‐grade dysplasia (114/918, 12.4%), followed by upgrades to intramucosal carcinoma (33/918, 3.6%), submucosal adenocarcinoma (10/918, 1.1%), and advanced adenocarcinoma (5/918, 0.5%). NSAID history (OR 4.83; 95% CI, 2.27‐10.27; p < 0.001), insufficient EFB number (OR 2.99; 95% CI, 1.91‐4.68; p < 0.001), maximum diameter ≥ 1.0 cm (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), surface unevenness (OR 2.31; 95% CI, 1.33‐4.01; p = 0.003), and distal location of the target adenoma (OR 3.29; 95% CI, 1.68‐6.41;...