Intest Res 2018; 16(3): 475-483  https://doi.org/10.5217/ir.2018.16.3.475
Histologic discrepancy between endoscopic forceps biopsy and endoscopic mucosal resection specimens of colorectal polyp in actual clinical practice
Moon Joo Hwang, Kyeong Ok Kim, A Lim Kim, Si Hyung Lee, Byung Ik Jang, Tae Nyeun Kim
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
Correspondence to: Kyeong Ok Kim, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea. Tel: +82-53-620-3830, Fax: +82-53-654-8386, E-mail: cello7727@naver.com
Received: January 23, 2018; Revised: March 3, 2018; Accepted: March 7, 2018; Published online: July 30, 2018.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims: We aimed to assess the rate of histologic discrepancy (HD) between endoscopic forceps biopsy (EFB) and totally resected specimens in colorectal polyp and analyze the risk factors of discordant group, especially under-diagnosis (UD) cases before complete removal of colorectal polyp. Methods: From 2010 to 2015, a total of 290 polyps in 210 patients which had baseline pathology report before endoscopic resection (ER) were analyzed. UD cases were defined as those in which the diagnosis changed to a more advanced histologic feature after ER. Results: A change in the final histology after ER was noted in 137 cases (47.2%), and after excluding 9 insignificant cases, 128 cases were further categorized into over-diagnosed and under-diagnosed group. UD occurred in 86 cases (29.7%) and change from benign to malignancy was noted in 26 cases (8.9%). On univariate analysis, a larger polyp size (>10 mm) was significantly associated with both HD (P<0.001) and UD (P<0.001). Regarding polyp morphology, protruding or flat was not significantly important. On multivariate analysis, polyp size >10 mm was the single most significant predictor of both HD (P<0.001) and UD (P<0.001). Conclusions: The HD and UD rates were 47.2% and 29.7%, respectively. Polyp size >10 mm was the most important predictor of both HD and UD. We should be careful in making treatment strategy of colorectal polyp based on histologic report of EFB especially when the size of polyp is >10 mm.
Keywords: Colorectal polyp; Histology; Discrepancy; Biopsy; Endoscopic mucosal resection


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