Endoscopic forceps biopsy is essential before planning an endoscopic resection of upper gastrointestinal epithelial tumors. However, forceps biopsy is limited by its superficiality and frequency of sampling errors. Histologic discrepancies between endoscopic forceps biopsies and resected specimens are frequent. Factors associated with such histologic discrepancies are tumor size, macroscopic type, surface color, and the type of medical facility. Precise targeting of biopsies is recommended to achieve an accurate diagnosis, curative endoscopic resection, and a satisfactory oncologic outcome. Multiple deep forceps biopsies can induce mucosal ulceration in early gastric cancer. Endoscopic resection for early gastric cancer with ulcerative findings is associated with piecemeal resection, incomplete resection, and a risk for procedure-related complications such as bleeding and perforation. Such active ulcers caused by forceps biopsy and following submucosal fibrosis might also be mistaken as an indication for more aggressive procedures, such as gastrectomy with D2 lymph node dissection. Proton pump inhibitors might be prescribed to facilitate the healing of biopsy-induced ulcers if an active ulcer is predicted after deep biopsy. It is unknown which time interval from biopsy to endoscopic resection is appropriate for a safe procedure and a good oncologic outcome. Further investigations are needed to conclude the appropriate time interval.

Citations

Citations to this article as recorded by  

• Success rate of current human-derived gastric cancer organoids establishment and influencing factors: A systematic review and meta-analysis
  Kai-Lin Jiang, Xiang-Xiang Wang, Xue-Jiao Liu, Li-Kun Guo, Yong-Qi Chen, Qing-Ling Jia, Ke-Ming Yang, Jiang-Hong Ling
  World Journal of Gastrointestinal Oncology.2024; 16(4): 1626.     CrossRef
• Clinical value and influencing factors of establishing stomach cancer organoids by endoscopic biopsy
  Jie Li, Yan Chen, Yingyi Zhang, Xiaobo Peng, Meihong Wu, Ling Chen, Xianbao Zhan
  Journal of Cancer Research and Clinical Oncology.2023; 149(7): 3803.     CrossRef
• Chinese integrated guideline on the management of gastric precancerous conditions and lesions
  Ping Wang, Peng Li, Yingxuan Chen, Li Li, Yuanyuan Lu, Weixun Zhou, Liqun Bian, Beihua Zhang, Xiaolan Yin, Junxiang Li, Jie Chen, Shutian Zhang, Yongquan Shi, Xudong Tang
  Chinese Medicine.2022;[Epub]     CrossRef
• Clinical applicability of gastroscopy with narrow-band imaging for the diagnosis of Helicobacter pylori gastritis, precancerous gastric lesion, and neoplasia
  Jun-Hyung Cho, Seong Ran Jeon, So-Young Jin
  World Journal of Clinical Cases.2020; 8(14): 2902.     CrossRef
• Gastric Cancer Caused by Adenoma: Predictive Factors Associated with Lesions Other Than the Expanded Indications
  Seong Hwan Park, Kee Don Choi, Kyoungwon Jung, Yangsoon Park, Sunpyo Lee, Eun Jeong Gong, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Jeong Hoon Lee, Do Hoon Kim, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
  Gut and Liver.2018; 12(3): 246.     CrossRef
• Risk factors associated with histological upgrade of gastric low‐grade dysplasia on pretreatment biopsy
  Lang Yang, Peng Jin, Xin Wang, Tong Zhang, Yu Qi He, Xiao Jun Zhao, Na Li, Guang Zhi Yang, Jian Qiu Sheng
  Journal of Digestive Diseases.2018; 19(10): 596.     CrossRef
• Endoscopic predictors for undifferentiated histology in differentiated gastric neoplasms prior to endoscopic resection
  Ji Min Choi, Sang Gyun Kim, Hyo-Joon Yang, Joo Hyun Lim, Jeongmin Choi, Jong Pil Im, Joo Sung Kim, Woo Ho Kim, Hyun Chae Jung
  Surgical Endoscopy.2016; 30(1): 89.     CrossRef
• Guidance on the effective use of upper gastrointestinal histopathology
  Maurice B Loughrey, Brian T Johnston
  Frontline Gastroenterology.2014; 5(2): 88.     CrossRef
• Endoscopic features suggesting gastric cancer in biopsy-proven gastric adenoma with high-grade neoplasia
  Jung Ho Kim
  World Journal of Gastroenterology.2014; 20(34): 12233.     CrossRef