Clinical implication of endoscopic gross appearance in early gastric cancer: Revisited

Da Hyun Jung, Yoo Mi Park, Jie Hyun Kim, Yong Chan Lee, Young Hoon Youn, Hyojin Park, Sang In Lee, Jong Won Kim, Seung Ho Choi, Woo Jin Hyung, Sung Hoon Noh

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13 Citations (Scopus)

Abstract

Background: The macroscopic appearance of early gastric cancer (EGC) is known to reflect its growth patterns. The purpose of this study was to investigate the role of the endoscopic appearance as a predictor of clinical behavior in EGC. Methods: Between January 2005 and December 2008, 1,845 patients were diagnosed with EGC and underwent surgery. The clinicopathologic characteristics were retrospectively analyzed according to gross appearance. Endoscopic findings were classified by predominant type as elevated, flat, or depressed. Flat and depressed types were categorized together as nonelevated type. Results: The proportions of elevated, flat, and depressed types were 16.6, 28.6, and 54.8 %. The gross appearance of the elevated type predominantly showed well/moderate differentiation, whereas the flat and depressed types showed signet-ring cells and poor differentiation, respectively. When the elevated and nonelevated types were compared, submucosal invasion, lymphovascular invasion (LVI), and lymph-node metastasis (LNM) were higher in elevated than in nonelevated type. In differentiated EGC, submucosal invasion, LVI, LNM, and multiplicity were significantly higher in the elevated than the nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. In undifferentiated EGC, submucosal invasion, LVI, and perineural invasion were significantly higher in elevated than in nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. However, LNM was not significantly different based on gross appearance in undifferentiated EGC. Conclusions: Clinical behavior differs according to endoscopic appearance in EGC. The endoscopic appearance of EGC may facilitate prediction of clinical behavior, particularly in differentiated EGC.

Original languageEnglish
Pages (from-to)3690-3695
Number of pages6
JournalSurgical endoscopy
Volume27
Issue number10
DOIs
Publication statusPublished - 2013 Oct

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Stomach Neoplasms
Lymph Nodes
Neoplasm Metastasis
Cell Differentiation
Growth

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Jung, Da Hyun ; Park, Yoo Mi ; Kim, Jie Hyun ; Lee, Yong Chan ; Youn, Young Hoon ; Park, Hyojin ; Lee, Sang In ; Kim, Jong Won ; Choi, Seung Ho ; Hyung, Woo Jin ; Noh, Sung Hoon. / Clinical implication of endoscopic gross appearance in early gastric cancer : Revisited. In: Surgical endoscopy. 2013 ; Vol. 27, No. 10. pp. 3690-3695.
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abstract = "Background: The macroscopic appearance of early gastric cancer (EGC) is known to reflect its growth patterns. The purpose of this study was to investigate the role of the endoscopic appearance as a predictor of clinical behavior in EGC. Methods: Between January 2005 and December 2008, 1,845 patients were diagnosed with EGC and underwent surgery. The clinicopathologic characteristics were retrospectively analyzed according to gross appearance. Endoscopic findings were classified by predominant type as elevated, flat, or depressed. Flat and depressed types were categorized together as nonelevated type. Results: The proportions of elevated, flat, and depressed types were 16.6, 28.6, and 54.8 {\%}. The gross appearance of the elevated type predominantly showed well/moderate differentiation, whereas the flat and depressed types showed signet-ring cells and poor differentiation, respectively. When the elevated and nonelevated types were compared, submucosal invasion, lymphovascular invasion (LVI), and lymph-node metastasis (LNM) were higher in elevated than in nonelevated type. In differentiated EGC, submucosal invasion, LVI, LNM, and multiplicity were significantly higher in the elevated than the nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. In undifferentiated EGC, submucosal invasion, LVI, and perineural invasion were significantly higher in elevated than in nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. However, LNM was not significantly different based on gross appearance in undifferentiated EGC. Conclusions: Clinical behavior differs according to endoscopic appearance in EGC. The endoscopic appearance of EGC may facilitate prediction of clinical behavior, particularly in differentiated EGC.",
author = "Jung, {Da Hyun} and Park, {Yoo Mi} and Kim, {Jie Hyun} and Lee, {Yong Chan} and Youn, {Young Hoon} and Hyojin Park and Lee, {Sang In} and Kim, {Jong Won} and Choi, {Seung Ho} and Hyung, {Woo Jin} and Noh, {Sung Hoon}",
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Clinical implication of endoscopic gross appearance in early gastric cancer : Revisited. / Jung, Da Hyun; Park, Yoo Mi; Kim, Jie Hyun; Lee, Yong Chan; Youn, Young Hoon; Park, Hyojin; Lee, Sang In; Kim, Jong Won; Choi, Seung Ho; Hyung, Woo Jin; Noh, Sung Hoon.

In: Surgical endoscopy, Vol. 27, No. 10, 10.2013, p. 3690-3695.

Research output: Contribution to journalArticle

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T2 - Revisited

AU - Jung, Da Hyun

AU - Park, Yoo Mi

AU - Kim, Jie Hyun

AU - Lee, Yong Chan

AU - Youn, Young Hoon

AU - Park, Hyojin

AU - Lee, Sang In

AU - Kim, Jong Won

AU - Choi, Seung Ho

AU - Hyung, Woo Jin

AU - Noh, Sung Hoon

PY - 2013/10

Y1 - 2013/10

N2 - Background: The macroscopic appearance of early gastric cancer (EGC) is known to reflect its growth patterns. The purpose of this study was to investigate the role of the endoscopic appearance as a predictor of clinical behavior in EGC. Methods: Between January 2005 and December 2008, 1,845 patients were diagnosed with EGC and underwent surgery. The clinicopathologic characteristics were retrospectively analyzed according to gross appearance. Endoscopic findings were classified by predominant type as elevated, flat, or depressed. Flat and depressed types were categorized together as nonelevated type. Results: The proportions of elevated, flat, and depressed types were 16.6, 28.6, and 54.8 %. The gross appearance of the elevated type predominantly showed well/moderate differentiation, whereas the flat and depressed types showed signet-ring cells and poor differentiation, respectively. When the elevated and nonelevated types were compared, submucosal invasion, lymphovascular invasion (LVI), and lymph-node metastasis (LNM) were higher in elevated than in nonelevated type. In differentiated EGC, submucosal invasion, LVI, LNM, and multiplicity were significantly higher in the elevated than the nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. In undifferentiated EGC, submucosal invasion, LVI, and perineural invasion were significantly higher in elevated than in nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. However, LNM was not significantly different based on gross appearance in undifferentiated EGC. Conclusions: Clinical behavior differs according to endoscopic appearance in EGC. The endoscopic appearance of EGC may facilitate prediction of clinical behavior, particularly in differentiated EGC.

AB - Background: The macroscopic appearance of early gastric cancer (EGC) is known to reflect its growth patterns. The purpose of this study was to investigate the role of the endoscopic appearance as a predictor of clinical behavior in EGC. Methods: Between January 2005 and December 2008, 1,845 patients were diagnosed with EGC and underwent surgery. The clinicopathologic characteristics were retrospectively analyzed according to gross appearance. Endoscopic findings were classified by predominant type as elevated, flat, or depressed. Flat and depressed types were categorized together as nonelevated type. Results: The proportions of elevated, flat, and depressed types were 16.6, 28.6, and 54.8 %. The gross appearance of the elevated type predominantly showed well/moderate differentiation, whereas the flat and depressed types showed signet-ring cells and poor differentiation, respectively. When the elevated and nonelevated types were compared, submucosal invasion, lymphovascular invasion (LVI), and lymph-node metastasis (LNM) were higher in elevated than in nonelevated type. In differentiated EGC, submucosal invasion, LVI, LNM, and multiplicity were significantly higher in the elevated than the nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. In undifferentiated EGC, submucosal invasion, LVI, and perineural invasion were significantly higher in elevated than in nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. However, LNM was not significantly different based on gross appearance in undifferentiated EGC. Conclusions: Clinical behavior differs according to endoscopic appearance in EGC. The endoscopic appearance of EGC may facilitate prediction of clinical behavior, particularly in differentiated EGC.

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