Biopsy is short for pathological examination of diseased tissues taken from patients’ biopsies. For clinical work, this examination method helps to make timely and accurate diagnosis of diseases and judge the efficacy of treatment. There are many kinds of stomach diseases, such as gastritis, chronic gastric ulcer, gastric polyp, gastric cancer, gastric lymphoma, gastric schistosomiasis, etc. Most of them can be detected by gastric biopsy. Especially in the early diagnosis of gastric cancer, gastric biopsy is widely used in clinical practice because of its unique advantages, which is considered as the magic weapon for early diagnosis of gastric cancer. The incidence status of gastric cancer in China Gastric cancer is one of the most common malignant tumors, and the mortality rate of gastric cancer in China is quite high, about 39.29/100,000, and it ranks first or second in the death statistics of malignant tumors in many regions. In addition to its high incidence rate, another directly related reason for such a high mortality rate of gastric cancer is that most patients are too late when they are diagnosed. The reasons for this are twofold. One of them is that the development of stomach cancer is insidious. The symptoms of stomach cancer itself are not clear and specific, and are very similar to those of indigestion. Secondly, the health care awareness of our residents is not strong enough. With the accelerated pace of life and increased work pressure, people usually do not take abdominal pain and bloating seriously, thinking that stomach diseases are like colds, which can be passed after a while, so that small diseases become big diseases and curable diseases become incurable diseases. According to statistics, more than 95% of gastric cancer patients in China have already reached the advanced stage of gastric cancer when they are diagnosed, while in developed countries with high incidence of gastric cancer, especially Japan, group census through widely used gastric biopsy and gastric exfoliative cytology examination has found a considerable number (up to 1/3) of early cases, and thus the corresponding survival rate is increasing. Therefore, it is not terrible to have gastric cancer, the key lies in the word “early”, the earlier it is detected, the more timely the treatment, and the better the curative effect. Gastric biopsy is a magic weapon for early diagnosis of gastric cancer. Gastric biopsy has the features of accurate diagnosis, simple operation, low risk and low pain, and it is not expensive either. What is more meaningful is that gastric biopsy can detect not only cancerous cells but also cells that have not yet become cancerous but have the tendency to become cancerous. Studies have shown that the development of gastric cancer is a long-term process, generally going through several stages, such as normal mucosa – mucosal heterogeneous proliferation – cellular carcinoma – infiltrative growth of cancer cells – spread of cancer cells. Gastric biopsy can detect mucosal heterotypic proliferation before the cells become cancerous, thus making it possible to prevent the disease before it happens. For example, chronic gastric ulcer (1% cancer rate) and chronic atrophic gastritis (CAG) are statistically more likely to become cancerous than other diseases, and these two diseases are called “precancerous diseases”, which require attention when gastric biopsy is performed to diagnose these two gastric diseases. The heterogeneous hyperplasia stage before cancer, also called atypical hyperplasia, refers to the abnormal proliferation of the glandular epithelium of the gastric mucosa. According to the degree of hyperplasia, it is classified as mild, moderate or severe. Among them, mild heterogeneous hyperplasia is reversible, has no important clinical significance, and does not require special treatment. Moderate and severe heterogeneous hyperplasia are closely related to carcinoma and should be given sufficient attention. In addition, some other terms are often used in pathology report forms. For example, “intestinal epithelial metaplasia” means that the epithelium of gastric mucosa loses its normal differentiation direction and becomes the epithelium of small or large intestine mucosa, whose relationship with carcinoma is not yet determined and generally no special treatment is needed. “Active lesion” refers to an acute attack of chronic inflammation, i.e. in the acute stage of chronic disease. Steps of gastric biopsy Gastric biopsy consists of two steps in summary. The first step is for the gastroscopist to insert the gastroscope from the patient’s mouth through the pharynx and esophagus into the stomach. After observing the lesion through the gastroscope and deciding to do a biopsy, small pieces of tissue (commonly called meat) are taken out of the lesion with a special biopsy forceps. The best gastroscope available is the electronic gastroscope. It was first used and done on the most patients at Concordia Hospital in the south central region. Compared with the old rubber gastroscope, the electronic gastroscope is small, soft and easy to bend, and easy to operate. Moreover, through the conduction of optical fiber, it can clearly transmit the situation inside the stomach to the TV screen, which is convenient for multiple people to observe and diagnose at the same time, thus breaking through the limitation that the old gastroscope can only be viewed by one gastroscopist. When the gastroscopist encounters a suspicious lesion, while observing the screen, he or she clamps a lesion about the size of a grain of rice and sends it for biopsy. When the tissue block is clamped, the patient feels like an ant bite and experiences only mild discomfort. The clamp leaves a very small wound and there is a small amount of gastric bleeding, but as long as you fast for a short time after surgery and take a few pills, you will be fine and it is not as scary as you think. Step 2: The tissue is sent to the pathology department, where it is cut into thin slices 3 to 5 microns thick and spread on a slide after a series of treatments, and then stained with various stains to make an observable section for diagnosis by the pathologist under a microscope. To determine the nature of the lesion is it inflammatory, or is it a tumor? If it is a tumor, is it benign or malignant? Which tissue source did the tumor cells occur from? As we all know, pathological examination has the highest accuracy rate among all examination methods and is regarded as the “gold standard” for diagnosis. Therefore, gastric biopsy, as a diagnostic tool relying on pathological examination, has high accuracy and authority for the diagnosis of gastric diseases, and accordingly, clinicians can formulate the most reliable treatment plan based on the pathological results of gastric biopsy. The most reliable treatment plan is formulated by clinicians based on the pathology results of gastric biopsy. Factors affecting the accuracy of gastric biopsy The most important factor affecting the accuracy of gastric biopsy is the diagnostic experience of the pathologist, while the gastroscopist’s clamping of the lesion’s vital parts is a prerequisite for ensuring the accuracy of biopsy. Some diseases require repeated biopsies to make a diagnosis due to the specificity of the lesion, e.g., gastric bursa. Therefore, when you feel discomfort in the abdomen, seek early diagnosis and treatment, and try to choose an experienced hospital when you need a gastric biopsy.