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2000
Volume 1, Issue 1
  • ISSN: 2949-7795
  • E-ISSN: 2949-7809

Abstract

Background/Introduction

Gastric cancer is prevalent in the Brazilian population, with diagnosis largely reliant on endoscopic biopsies. Current guidelines recommend a minimum of seven endoscopic biopsies. However, advances in high-definition imaging, chromoendoscopy technologies (such as narrow-band imaging [NBI]), and histopathological techniques suggest that fewer biopsies might suffice. Validating this hypothesis could reduce the duration of examinations, lessen the burden on pathologists, and minimize risks associated with multiple biopsies.

Methods

This prospective study evaluated the efficacy of various biopsy strategies in diagnosing gastric lesions. A total of 106 lesions from 104 patients were examined over 14 months. The study compared the diagnostic yield of the conventional seven biopsies (considered the gold standard) with a single white-light biopsy, one NBI-guided biopsy, and a combination of both white-light and NBI-guided biopsies.

Results and Discussion

When compared to the gold standard of seven biopsies, the single white-light biopsy demonstrated a sensitivity of 90.1% (range 82.5-95.6%) and a specificity of 100% (range 47.8-100%). The NBI-guided biopsy yielded a sensitivity of 83.2% (range 74.4-89.9%) and a specificity of 100% (range 47.8-100%). Combining both biopsy techniques achieved a sensitivity of 96.1% and a specificity of 100%.

Conclusion

A single white-light biopsy was found to be nearly equivalent to the gold standard of seven biopsies, using a 10% difference as the noninferiority criterion. Performing two biopsies-one conventional and one NBI-guided-provided even greater accuracy, closely approximating that of the gold standard.

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2025-09-01
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References

  1. Atlas on line de mortalidadeAvailable from:https://mortalidade.inca.gov.br/MortalidadeWeb/
  2. FaigelD. EisenG. BaronT. DominitzJ. GoldsteinJ. HirotaW. JacobsonB. JohansonJ. LeightonJ. MalleryJ. PetersonK.A. RaddawiH.M. VargJ.J.II WaringJ.P. FanelliR.D. Wheeler-HarboughJ. Tissue sampling and analysis.Gastrointest. Endosc.200357781181610.1016/S0016‑5107(03)70047‑912776025
    [Google Scholar]
  3. HatfieldA.R. SlavinG. SegalA.W. LeviA.J. Importance of the site of endoscopic gastric biopsy in ulcerating lesions of the stomach.Gut1975161188488610.1136/gut.16.11.8841193417
    [Google Scholar]
  4. WoodsK.L. AnandB.S. ColeR.A. OsatoM.S. GentaR.M. MalatyH. GurerI.E. De RossiD. Influence of endoscopic biopsy forceps characteristics on tissue specimens: Results of a prospective randomized study.Gastrointest. Endosc.199949217718310.1016/S0016‑5107(99)70483‑99925695
    [Google Scholar]
  5. CookI.J. de CarleD.J. HanemanB. HuntD.R. TalleyN.A. MillerD. The role of brushing cytology in the diagnosis of gastric malignancy.Acta Cytol.19883244614643041720
    [Google Scholar]
  6. EvansJ.A. ChandrasekharaV. ChathadiK.V. DeckerG.A. EarlyD.S. FisherD.A. FoleyK. HwangJ.H. JueT.L. LightdaleJ.R. PashaS.F. SharafR. ShergillA.K. CashB.D. DeWittJ.M. The role of endoscopy in the management of premalignant and malignant conditions of the stomach.Gastrointest. Endosc.20158211810.1016/j.gie.2015.03.196725935705
    [Google Scholar]
  7. GrahamD.Y. SchwartzJ.T. CainG.D. GyorkeyF. Prospective evaluation of biopsy number in the diagnosis of esophageal and gastric carcinoma.Gastroenterology198282222823110.1016/0016‑5085(82)90009‑97054024
    [Google Scholar]
  8. BanerjeeR. ReddyD.N. Advanced gastrointestinal endoscopy.A primer on Narrow Band Imaging.Book2009
    [Google Scholar]
  9. NiikuraR. AokiT. ShichijoS. YamadaA. KawaharaT. KatoY. HirataY. HayakawaY. SuzukiN. OchiM. HirasawaT. TadaT. KawaiT. KoikeK. Artificial intelligence versus expert endoscopists for diagnosis of gastric cancer in patients who have undergone upper gastrointestinal endoscopy.Endoscopy202254878078410.1055/a‑1660‑650034607377
    [Google Scholar]
  10. ParkY.S. KookM.C. KimB. LeeH.S. KangD.W. GuM.J. ShinO.R. ChoiY. LeeW. KimH. SongI.H. KimK.M. KimH.S. KangG. ParkD.Y. JinS.Y. KimJ.M. ChoiY.J. ChangH.K. AhnS. ChangM.S. HanS.H. KwakY. SeoA.N. LeeS.H. ChoM.Y. A standardized pathology report for gastric cancer.J. Gastric Cancer202323110714510.5230/jgc.2023.23.e736750994
    [Google Scholar]
  11. IwashitaT. YasudaI. MukaiT. DoiS. NakashimaM. UemuraS. MabuchiM. ShimizuM. HatanoY. HaraA. MoriwakiH. Macroscopic on-site quality evaluation of biopsy specimens to improve the diagnostic accuracy during EUS-guided FNA using a 19-gauge needle for solid lesions: A single-center prospective pilot study (MOSE study).Gastrointest. Endosc.201581117718510.1016/j.gie.2014.08.04025440688
    [Google Scholar]
  12. NavaneethanU. NjeiB. VenkateshP.G.K. VargoJ.J. ParsiM.A. Fluorescence in situ hybridization for diagnosis of cholangiocarcinoma in primary sclerosing cholangitis: A systematic review and meta-analysis.Gastrointest. Endosc.2014796943950.e310.1016/j.gie.2013.11.00124360654
    [Google Scholar]
  13. GulloI. GrilloF. MolinaroL. FassanM. De SilvestriA. TinelliC. RuggeM. FioccaR. MastracciL. Minimum biopsy set for HER2 evaluation in gastric and gastro-esophageal junction cancer.Endosc. Int. Open201532E165E17010.1055/s‑0034‑139135926135662
    [Google Scholar]
  14. HanK.S. SohnD.K. ChoiD.H. HongC.W. ChangH.J. LimS.B. ChoiH.S. JeongS.Y. ParkJ.G. Prolongation of the period between biopsy and EMR can influence the nonlifting sign in endoscopically resectable colorectal cancers.Gastrointest. Endosc.20086719710210.1016/j.gie.2007.05.05718155430
    [Google Scholar]
  15. BorrmannR. Geschwulste des marges und Duodenums.Handbuchspezpatholanat und histo. HenkeF. LubarschO. Springer1926864871
    [Google Scholar]
  16. LaurA(c)nP. The two histological main types of gastric carcinoma: Diffuse and so called intestinal-type carcinoma, an attempt at a histo-clinical classification.Acta Pathol. Microbiol. Scand.1965641314910.1111/apm.1965.64.1.3114320675
    [Google Scholar]
  17. ArkinCF WachtelMS How many patients are necessary to assess test performance?JAMA19902632275810.1001/jama.1990.03440020109043
    [Google Scholar]
  18. KarimiP. IslamiF. AnandasabapathyS. FreedmanN.D. KamangarF. Gastric cancer: Descriptive epidemiology, risk factors, screening, and prevention.Cancer Epidemiol. Biomarkers Prev.201423570071310.1158/1055‑9965.EPI‑13‑105724618998
    [Google Scholar]
  19. LalN. BhasinD.K. MalikA.K. GuptaN.M. SinghK. MehtaS.K. Optimal number of biopsy specimens in the diagnosis of carcinoma of the oesophagus.Gut199233672472610.1136/gut.33.6.7241624148
    [Google Scholar]
  20. ChoiY. ChoiH.S. JeonW.K. KimB.I. ParkD.I. ChoY.K. KimH.J. ParkJ.H. SohnC.I. Optimal number of endoscopic biopsies in diagnosis of advanced gastric and colorectal cancer.J. Korean Med. Sci.2012271363910.3346/jkms.2012.27.1.3622219611
    [Google Scholar]
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  • Article Type:
    Research Article
Keyword(s): biopsy; cancer; digestive tract; endoscopy; Gastric; malignancy
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