Komatsu S, Ichikawa D, Miyamae M, Kosuga T, Konishi H, Shiozaki A, Fujiwara H, Okamoto K, Kishimoto M, Otsuji E. Discrepancies in the histologic type between biopsy and resected specimens: A cautionary note for mixed-type gastric carcinoma. World J Gastroenterol 2015; 21(15): 4673-4679 [PMID: 25914478 DOI: 10.3748/wjg.v21.i15.4673]
Corresponding Author of This Article
Shuhei Komatsu, MD, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. skomatsu@koto.kpu-m.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shuhei Komatsu, Daisuke Ichikawa, Mahito Miyamae, Toshiyuki Kosuga, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Kazuma Okamoto, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Mitsuo Kishimoto, Department of Surgical Pathology, Kyoto Prefectural University of Medicine, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan
Author contributions: Komatsu S, Ichikawa D, Miyamae M, Kosuga T, Konishi H, Shiozaki A, Fujiwara H, Okamoto K, Kishimoto M and Otsuji E performed the research; Komatsu S and Miyamae M analyzed the data; and Komatsu S wrote the paper.
Ethics approval: This study was institutionally approved by Kyoto Prefectural University of Medicine.
Informed consent: Subjects provided signed informed consent. Patients were treated according to the provisions of the Helsinki criteria to conduct research involving human subjects.
Conflict-of-interest: We have no conflict of interest to disclose.
Data sharing: There is no data for sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shuhei Komatsu, MD, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachihirokoji, Kamigyo-ku, Kyoto 602-8566, Japan. skomatsu@koto.kpu-m.ac.jp
Telephone: +81-75-2515527 Fax: +81-75-2515522
Received: November 5, 2014 Peer-review started: November 5, 2014 First decision: December 11, 2014 Revised: December 30, 2014 Accepted: January 30, 2015 Article in press: January 30, 2015 Published online: April 21, 2015 Processing time: 166 Days and 10.4 Hours
Abstract
AIM: To evaluate discrepancies between biopsy and resected specimens using the Japanese Classification of Gastric Carcinoma (JCGC) and tumor-node-metastasis (TNM) classification.
METHODS: A total of 376 consecutive paired samples from biopsy and resected gastric specimens, which were derived from curative gastrectomy for gastric cancer between 2008 and 2011, were retrospectively analyzed.
RESULTS: (1) Discrepancies in the histologic type were observed between biopsy and resected specimens; 11.7% (44/376) in the JCGC and 18.1% (68/376) in TNM. In specimens diagnosed as the differentiated type from biopsy specimens, 14.4% (28/195) in the JCGC and 41.1% (67/163) in TNM were finally diagnosed as the undifferentiated type from resected specimens; and (2) the incidence of mixed-type gastric cancer was significantly higher in specimens with discrepancies than in those without in both the JCGC and TNM (both P < 0.0001); 93.2% (41/44) of specimens with discrepancies in the JCGC and 97.1% (66/68) of specimens with discrepancies in TNM were mixed-type gastric cancers.
CONCLUSION: Mixed-type gastric cancer was associated with a high incidence of histologic discrepancies between biopsy and resected specimens in both the JCGC and TNM definitions. Care should be taken in deciding treatments based on diagnosis of the histologic type for mixed-type gastric cancer from biopsy specimens.
Core tip: Little is known about diagnostic discrepancies in the histologic type between biopsy and resected specimens in gastric cancer. We demonstrate that mixed-type gastric cancer is associated with a high incidence of histologic discrepancy between biopsy and resected specimens in both the Japanese Classification of Gastric Carcinoma and tumor-node-metastasis definitions.
