Comparative Study On Endoscopic Morphology Interpretation By Different Endoscopic Physicians And Pathology Of Early Gastric Cancer

Aim Research the application status on endoscopic morphology of early gastric cancer and compare the consistency between endoscopic judgment and pathology of early gastric cancer.Methods We select patients who were diagnosed early gastric cancer with pathologically from January 2016-2017 December in the department of gastroenterology in Beijing Friendship Hospital,Capital Medical University,then three endoscopic physicians read the endoscopic morphology of the lesions respectively,and a pathologist reviews the pathologic results.We count the same proportion of the results of the three endoscopic physicians and make the consistency check between the endoscopic diagnosis and pathologic diagnosis.Then we use the SPSS21.0 software to make the statistical analysis.Results1.A total of 74 patients were included in this study,with 56 male and 18 female,the mean age was 62.42±9.10 years.The lesion was located in the preventriculus,the upper part of the stomach,the middle part of the stomach,and the lower part of the stomach with 3 cases,4cases,23 cases and 44 cases respectively.The namber of the cases whose type of I,IIa,IIb,IIc type and IIa+IIc were 3,17,6,15 and 33 respectively.There were 56 cases,10 cases,3cases and 5 cases of high differentiation,middle differentiation,low differentiation and mixed type respectively.The invasion depth in M,SM1(<500um),and SM2(>500um)with 68 cases,4 cases and 2 cases respectively.2.The higher percentage of the same results between the three doctors in the lesion colorand the changes of the mucosal folds near the lesion with conventional endoscopy were94.0% and 91.9% respectively,but tthe ‘‘non-extension sign’’ was the lowest,it just 9.5%.3.The percentage of the same results between the three doctors in demarcation line,microvascular architecture and microsurface structure of the lesion with Magnifying endoscopy were 91.1%、56.8%、52.7% respectively.4.Te percentage of the same results between the three doctors in White opaque substance,white globe appearance and Light blue crest with Magnifying endoscopy were 58.1%、39.2%、97.3% respectively.5.The endoscopic diagnosis of experts A,B and C in lesion’ invasion depth,correspondingly the κ statistics which is consistent with pathology were 0.213,0.373 and 0.413 respectively.The endoscopic diagnosis in lesion’ degrees of differentiation of experts A,B and C,the κ statistics were 0.413.、0.528、0.269 respectively.Conclusion The practical application in endoscopic morphology of early gastric cancer has high subjective difference.