Xu Qin, Yang Jinlei, Shi Zhenwang, Fang Dong, Bao Deming, Wang Liming
Department of Gastroenterology, The Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University, Hefei, China.
Department of Thoracic Surgery, The First People's Hospital of Hefei, The Third Affiliated Hospital of Anhui Medical University, Hefei, China.
Front Oncol. 2025 Jun 12;15:1569739. doi: 10.3389/fonc.2025.1569739. eCollection 2025.
Gastric cancer remains one of the most lethal malignancies worldwide. Endoscopic submucosal dissection (ESD), a minimally invasive procedure that has become the gold standard for early-stage gastric cancer management, demonstrates both diagnostic and therapeutic utility. With advancing ESD techniques and expanded clinical applications, discrepancies between preoperative biopsy findings and post-resection pathology evaluations have become increasingly evident in clinical practice. This retrospective analysis of 113 ESD-treated patients employed systematic comparative methods to quantify diagnostic discrepancies between initial biopsy interpretations and definitive histopathological assessments, while identifying critical contributing factors. Multivariate analysis revealed three independent predictors of histopathological discrepancies including lesion location, lesions exhibiting type IIc morphology and elevated Kyoto Gastric Cancer Risk Scores. These findings provide robust statistical evidence for refining preoperative risk stratification protocols, ultimately optimizing clinical outcomes in precision endoscopy.
胃癌仍然是全球最致命的恶性肿瘤之一。内镜黏膜下剥离术（ESD）是一种微创手术，已成为早期胃癌治疗的金标准，具有诊断和治疗双重作用。随着ESD技术的进步和临床应用的扩大，术前活检结果与切除后病理评估之间的差异在临床实践中越来越明显。这项对113例接受ESD治疗患者的回顾性分析采用系统比较方法，以量化初始活检解读与最终组织病理学评估之间的诊断差异，同时确定关键影响因素。多变量分析揭示了组织病理学差异的三个独立预测因素，包括病变位置、表现为IIc型形态的病变以及京都胃癌风险评分升高。这些发现为完善术前风险分层方案提供了有力的统计证据，最终优化精准内镜检查的临床结果。
