Korean Journal of Gastrointestinal Endoscopy 2008;37(1): 14-19.
대장용종에서 겸자생검과 내시경절제술 사이의 병리소견 차이
송인도ㆍ김정욱ㆍ오인수
중앙대학교 의과대학 내과학교실
The Pathological Differences of Colorectal Polyps Examined between the Use of a Forcep Biopsy and Endoscopic Resection
In Do Song, M.D., Jeong Wook Kim, M.D. and In Soo Oh, M.D.
Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
Abstract
Background/Aims: Complete excision of colorectal polyps is not always performed for various reasons. We investigated the discrepancy between the histologic findings of polyps excised by a forcep biopsy and histologic findings of polyps excised by endoscopic resection. Methods: We reviewed 137 patients with 206 colorectal polyps removed by endoscopic resection following forcep biopsies. Endoscopic records and pathological reports of patients were analyzed retrospectively. Results: The discrepancy of the histological type was 18.4% between the histologic findings of a polyp evaluated after a forceps biopsy and the histologic findings of a polyp evaluated after endoscopic resection. The discrepancy of high-grade dysplasia (HGD) and a cancerous condition was 22.3% using the two procedures. A total of 15.5% of adenomas without HGD and 3.0% of hyperplasia in the forcep biopsy specimens were identified as adenomas with HGD in the resected specimens. A total of 18.2% of adenomas with HGD and 4.1% of adenomas without HGD in the forcep biopsy specimens were identified as adenomas with carcinoma in the resected specimens. The discrepancy rates of the histological type for HGD and a cancerous condition were high for penduculated polyps with a diameter of less than 10 mm and for polyps with a diameter of greater than 16 mm. Conclusions: Approaches to review the histology of an entire colorectal polyp should be performed, especially for polyps with an adenomatous histology and for polyps of the pedunculated form with a diameter of less than 10 mm and a diameter of greater than 16 mm after a forcep biopsy. (Korean J Gastrointest Endosc 2008;37:14-19)
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