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Tissue sampling and analysis
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DOI：10.1016/S0016-5107(03)70047-9.png)
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Abstract
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This is one of a series of statements discussing the utilization of gastrointestinal endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for the appropriate use of endoscopy are based on a critical review of the available data and expert consensus. Controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical considerations may justify a course of action at variance from these recommendations. This document replaces the previously published document Tissue Sampling and Analysis, Gastrointestinal Endoscopy 1991;37:633-5. The purpose of this statement is to provide a practical basis for tissue analysis (biopsy, snare excision, cytology, and culture) during GI endoscopy. Histopathologic evaluation is helpful to differentiate malignant, inflammatory, and infectious processes. Tissue biopsy specimens are routinely obtained from any suspicious lesion during endoscopic evaluation. When the gross endoscopic appearance is normal, histologic analysis may still provide useful information. Tissue analysis is occasionally performed to document the outcome of prior endoscopic or medical therapy. When the gross endoscopic appearance reveals a specific condition, tissue analysis is unnecessary if therapy will not be altered. Tissue biopsy should be avoided when there is an increased potential for hemorrhage such as in patients with coagulopathies.
Keywords:
HIGH-GRADE DYSPLASIA
METHYLENE-BLUE CHROMOENDOSCOPY
ENDOSCOPIC MUCOSAL RESECTION
SELF-LIMITED COLITIS
HELICOBACTER-PYLORI
BARRETTS-ESOPHAGUS
INTESTINAL METAPLASIA
COLLAGENOUS COLITIS
CANDIDA ESOPHAGITIS
NONINVASIVE TESTS
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