PMID- 32679601
OWN - NLM
STAT- MEDLINE
DCOM- 20210426
LR  - 20210426
IS  - 1438-8812 (Electronic)
IS  - 0013-726X (Print)
IS  - 0013-726X (Linking)
VI  - 53
IP  - 3
DP  - 2021 Mar
TI  - Single-bite versus double-bite technique for mapping biopsies during endoscopic 
      surveillance for hereditary diffuse gastric cancer: a single-center, randomized 
      trial.
PG  - 246-253
LID - 10.1055/a-1201-3125 [doi]
AB  - BACKGROUND : Endoscopic surveillance is recommended in patients with hereditary 
      diffuse gastric cancer (HDGC) who refuse or want to delay surgery. Because early 
      signet-ring cell carcinoma (SRCC) can be inconspicuous, the current surveillance 
      endoscopy protocol entails 30 random biopsies, which are time-consuming. This 
      study aimed to compare single-bite and double-bite techniques in HDGC 
      surveillance. METHODS : Between October 2017 and December 2018, consecutive 
      patients referred for HDGC surveillance were prospectively randomized to the 
      single- or double-bite arm. The primary outcome was the diagnostic yield for SRCC 
      foci. Secondary outcomes were: procedural time for random biopsies; comfort 
      score; biopsy size; and quality of specimens, the latter assessed by the presence 
      of muscularis mucosa, crush artifact, and proportion usable for diagnostic 
      assessment. RESULTS : 25 patients were randomized to the single-bite arm and 23 
      to the double-bite arm. SRCC foci were detected in three and four patients in the 
      single- and double-bite arms, respectively (P = 0.70). The procedural time for 
      the double-bite arm (12 minutes, interquartile range [IQR] 4) was significantly 
      shorter than for the single-bite arm (15 minute, IQR 6; P = 0.01), but comfort 
      scores were similar. The size of the biopsies in the double-bite arm was 
      significantly smaller than in single-bite arm (2.5 mm vs. 3.0 mm; P < 0.001) but 
      this did not affect the presence of muscularis mucosa (P = 0.73), artifact level 
      (P = 0.11), and diagnostic utility (P = 0.051). CONCLUSION : For patients 
      undergoing HDGC surveillance, the double-bite technique is significantly faster 
      than the single-bite technique. The diagnostic yield for SRCC and the biopsy 
      quality were similar across both groups.
CI  - Thieme. All rights reserved.
FAU - Pappas, Apostolos
AU  - Pappas A
AD  - MRC Cancer Unit, University of Cambridge, Cambridge, UK.
FAU - Tan, Wei Keith
AU  - Tan WK
AD  - MRC Cancer Unit, University of Cambridge, Cambridge, UK.
AD  - Department of Gastroenterology, Addenbrookes Hospital, Cambridge University NHS 
      Foundation Trust, Cambridge, UK.
AD  - Department of Gastroenterology, Hinchingbrooke Hospital, Huntingdon, UK.
FAU - Waldock, William
AU  - Waldock W
AD  - MRC Cancer Unit, University of Cambridge, Cambridge, UK.
FAU - Richardson, Susan
AU  - Richardson S
AD  - Department of Oncology, Addenbrookes Hospital, Cambridge University NHS 
      Foundation Trust, Cambridge, UK.
FAU - Tripathi, Monika
AU  - Tripathi M
AD  - Department of Histopathology, Addenbrookes Hospital, Cambridge University NHS 
      Foundation Trust, Cambridge, UK.
FAU - Januszewicz, Wladyslaw
AU  - Januszewicz W
AD  - MRC Cancer Unit, University of Cambridge, Cambridge, UK.
AD  - Department of Gastroenterology, Hepatology and Clinical Oncology, Medical Center 
      for Postgraduate Education, Warsaw, Poland.
FAU - Roberts, Geoffrey
AU  - Roberts G
AD  - Department of Surgery, Addenbrookes Hospital, Cambridge University NHS Foundation 
      Trust, Cambridge, UK.
FAU - O'Donovan, Maria
AU  - O'Donovan M
AD  - Department of Histopathology, Addenbrookes Hospital, Cambridge University NHS 
      Foundation Trust, Cambridge, UK.
FAU - Fitzgerald, Rebecca C
AU  - Fitzgerald RC
AD  - MRC Cancer Unit, University of Cambridge, Cambridge, UK.
FAU - di Pietro, Massimiliano
AU  - di Pietro M
AD  - MRC Cancer Unit, University of Cambridge, Cambridge, UK.
LA  - eng
SI  - ClinicalTrials.gov/NCT03950908
GR  - A21102/CRUK_/Cancer Research UK/United Kingdom
PT  - Clinical Trial
PT  - Randomized Controlled Trial
DEP - 20200717
PL  - Germany
TA  - Endoscopy
JT  - Endoscopy
JID - 0215166
RN  - 0 (Cadherins)
SB  - IM
CIN - Endoscopy. 2021 Mar;53(3):v13. PMID: 33631824
MH  - Biopsy
MH  - Cadherins
MH  - *Carcinoma, Signet Ring Cell/surgery
MH  - Gastrectomy
MH  - Gastroscopy
MH  - Humans
MH  - *Stomach Neoplasms/surgery
PMC - PMC7116833
MID - EMS86657
COIS- The authors declare that they have no conflict of interest.
EDAT- 2020/07/18 06:00
MHDA- 2021/04/27 06:00
PMCR- 2021/03/01
CRDT- 2020/07/18 06:00
PHST- 2020/07/18 06:00 [pubmed]
PHST- 2021/04/27 06:00 [medline]
PHST- 2020/07/18 06:00 [entrez]
PHST- 2021/03/01 00:00 [pmc-release]
AID - 10.1055/a-1201-3125 [doi]
PST - ppublish
SO  - Endoscopy. 2021 Mar;53(3):246-253. doi: 10.1055/a-1201-3125. Epub 2020 Jul 17.