Tu1522 CLINICAL IMPLICATIONS AND RISK FACTORS FOR HIGH-GRADE DYSPLASIA OR CARCINOMA IN BIOPSY-PROVEN GASTRIC REGENERATIVE ATYPIA

Abstract

Tissue biopsies are routinely performed during gastroscopy, however, the clinical implications and therapeutic strategies of lesions identified as regenerative atypia (RA) remain unclear. This study analyzed the clinical implications and risk factors for high-grade adenoma or carcinoma in patients with biopsy proven gastric RA. Between January, 2015, and December, 2016, 296 patients were diagnosed as RA after initial forceps biopsy performed during gastroscopy at Jeju National University Hospital. We retrospectively reviewed medical records, pathologic reports, and endoscopic findings. The detection rate of RA was 1.46% (296/20,271) among patients who underwent gastroscopy. Of 96 RA lesions that met eligibly criteria, 23 (24.0%) were neoplasia according to the final diagnosis; 14 (14.6%) were high-grade dysplasia or carcinoma, and 9 (9.4%) were low-grade dysplasia. Surface nodularity, surface redness, corporal lesions, and intestinal metaplasia were identified as risk factors in the univariate analysis. Multivariate analysis adjusted for age and sex showed that only surface nodularity among endoscopic findings was a statistically significant independent risk factor for highgrade dysplasia or carcinoma (p = 0.01; odds ratio, 6.4; 95% confidence interval, 1.5-26.4). Most patients initially diagnosed as RA were finally diagnosed with benign lesions such as gastritis and low-grade dysplasia. However, RA has potential that can be changed and upgraded to high-grade adenoma or carcinoma in the final diagnosis. Close follow-up observation is needed in the presence of risk factors such as surface nodularity.Table 2Risk factors for gastric high-grade dysplasia or carcinoma in cases of regenerative atypia identified by univariate and multivariate analyses.View Large Image Figure ViewerDownload Hi-res image Download (PPT)