Histological Features of Peptic Ulceration and Biopsy Scar of Gastric ESD Specimen Tadakazu Shimoda 1 , Ryoji Kushima 2 , Hiroyuki Ono 3 1National Cancer Center, Center for Cancer Control and Information Services, Tokyo 2Pathology Division, National Cancer Center Hospital, Tokyo 3Department of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan Keyword: 胃癌 , ESD/EMR , 標準治療 , 消化性潰瘍 , 生検瘢痕 pp.16-24
Published Date 2013/1/25
DOI https://doi.org/10.11477/mf.1403113696
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 As EMR(endoscopic mucosal resection)and ESD(endoscopic submucosal dissection)for early gastric cancer are being more widely performed, resection with broader application than standard treatment according to the Gastric Cancer Treatment Guidelines is more frequently performed. The coexistence of peptic ulcer within carcinoma lesions is one of the risk factors of lymph node metastasis. Therefore, determining the presence of peptic ulcer in resected specimens is very important. However, it is sometimes difficult to differentiate between ulcer scars, especially UL-II scars, and scars from biopsy before surgery. Most biopsy scars are highly localized changes in the muscularis mucosae and submucosa, but ulcer scars display fibrosis of all submucosal layers, exceeding the range of muscularis mucosae.

 However, the two are still difficult to differentiate when only a small amount of submucosa is resected.

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