Endoscopic and clinicopathologic characteristics of early gastric cancer with high microsatellite instability

Jaehoon Jahng, Young Hoon Youn, Kwang Hyun Kim, Junghwan Yu, Yongchan Lee, WooJin Hyung, Sung Hoon Noh, Hyunki Kim, Hogeun Kim, HyoJin Park, Sang In Lee

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Abstract

AIM: To investigate endoscopic and clinicopathologic characteristics of early gastric cancer (EGC) according to microsatellite instability phenotype. METHODS: Data were retrospectively collected from a single tertiary referral center. Of 981 EGC patients surgically treated between December 2003 and October 2007, 73 consecutive EGC patients with two or more microsatellite instability (MSI) mutation [high MSI (MSI-H)] and 146 consecutive EGC patients with one or no MSI mutation (non-MSI-H) were selected. The endoscopic and clinicopathologic features were compared between the MSI-H and non-MSI-H EGC groups. RESULTS: In terms of endoscopic characteristics, MSI-H EGCs more frequently presented with elevated pattern (OR 4.38, 95% CI: 2.40-8.01, P < 0.001), moderate-to-severe atrophy in the surrounding mucosa (OR 1.91, 95% CI: 1.05-3.47, P = 0.033), antral location (OR 3.99, 95% CI: 2.12-7.52, P < 0.001) and synchronous lesions, compared to non-MSI-H EGCs (OR 2.65, 95% CI: 1.16-6.07, P = 0.021). Other significant clinicopathologic characteristics of MSI-H EGC included predominance of female sex (OR 2.77, 95% CI: 1.53-4.99, P < 0.001), older age (> 70 years) (OR 3.30, 95% CI: 1.57-6.92, P = 0.002), better histologic differentiation (OR 2.35, 95% CI: 1.27-4.34, P = 0.007), intestinal type by Lauren classification (OR 2.34, 95% CI: 1.15-4.76, P = 0.019), absence of a signet ring cell component (OR 2.44, 95% CI: 1.02-5.86, P = 0.046), presence of mucinous component (OR 5.06, 95% CI: 1.27-20.17, P = 0.022), moderate-to-severe lymphoid stromal reaction (OR 3.95, 95% CI: 1.59-9.80, P = 0.003), and co-existing underlying adenoma (OR 2.66, 95% CI: 1.43-4.95, P = 0.002). CONCLUSION: MSI-H EGC is associated with unique endoscopic and clinicopathologic characteristics including frequent presentation in protruded type, co-existing underlying adenoma, and synchronous lesions.

Original languageEnglish
Pages (from-to)3571-3577
Number of pages7
JournalWorld Journal of Gastroenterology
Volume18
Issue number27
DOIs
Publication statusPublished - 2012 Jul 21

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Microsatellite Instability
Stomach Neoplasms
Adenoma
Mutation
Cellular Structures
Tertiary Care Centers
Phenotype

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Jahng, Jaehoon ; Youn, Young Hoon ; Kim, Kwang Hyun ; Yu, Junghwan ; Lee, Yongchan ; Hyung, WooJin ; Noh, Sung Hoon ; Kim, Hyunki ; Kim, Hogeun ; Park, HyoJin ; Lee, Sang In. / Endoscopic and clinicopathologic characteristics of early gastric cancer with high microsatellite instability. In: World Journal of Gastroenterology. 2012 ; Vol. 18, No. 27. pp. 3571-3577.
@article{1ffc24296f8d4915b9baf0dbf36aeff1,
title = "Endoscopic and clinicopathologic characteristics of early gastric cancer with high microsatellite instability",
abstract = "AIM: To investigate endoscopic and clinicopathologic characteristics of early gastric cancer (EGC) according to microsatellite instability phenotype. METHODS: Data were retrospectively collected from a single tertiary referral center. Of 981 EGC patients surgically treated between December 2003 and October 2007, 73 consecutive EGC patients with two or more microsatellite instability (MSI) mutation [high MSI (MSI-H)] and 146 consecutive EGC patients with one or no MSI mutation (non-MSI-H) were selected. The endoscopic and clinicopathologic features were compared between the MSI-H and non-MSI-H EGC groups. RESULTS: In terms of endoscopic characteristics, MSI-H EGCs more frequently presented with elevated pattern (OR 4.38, 95{\%} CI: 2.40-8.01, P < 0.001), moderate-to-severe atrophy in the surrounding mucosa (OR 1.91, 95{\%} CI: 1.05-3.47, P = 0.033), antral location (OR 3.99, 95{\%} CI: 2.12-7.52, P < 0.001) and synchronous lesions, compared to non-MSI-H EGCs (OR 2.65, 95{\%} CI: 1.16-6.07, P = 0.021). Other significant clinicopathologic characteristics of MSI-H EGC included predominance of female sex (OR 2.77, 95{\%} CI: 1.53-4.99, P < 0.001), older age (> 70 years) (OR 3.30, 95{\%} CI: 1.57-6.92, P = 0.002), better histologic differentiation (OR 2.35, 95{\%} CI: 1.27-4.34, P = 0.007), intestinal type by Lauren classification (OR 2.34, 95{\%} CI: 1.15-4.76, P = 0.019), absence of a signet ring cell component (OR 2.44, 95{\%} CI: 1.02-5.86, P = 0.046), presence of mucinous component (OR 5.06, 95{\%} CI: 1.27-20.17, P = 0.022), moderate-to-severe lymphoid stromal reaction (OR 3.95, 95{\%} CI: 1.59-9.80, P = 0.003), and co-existing underlying adenoma (OR 2.66, 95{\%} CI: 1.43-4.95, P = 0.002). CONCLUSION: MSI-H EGC is associated with unique endoscopic and clinicopathologic characteristics including frequent presentation in protruded type, co-existing underlying adenoma, and synchronous lesions.",
author = "Jaehoon Jahng and Youn, {Young Hoon} and Kim, {Kwang Hyun} and Junghwan Yu and Yongchan Lee and WooJin Hyung and Noh, {Sung Hoon} and Hyunki Kim and Hogeun Kim and HyoJin Park and Lee, {Sang In}",
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Endoscopic and clinicopathologic characteristics of early gastric cancer with high microsatellite instability. / Jahng, Jaehoon; Youn, Young Hoon; Kim, Kwang Hyun; Yu, Junghwan; Lee, Yongchan; Hyung, WooJin; Noh, Sung Hoon; Kim, Hyunki; Kim, Hogeun; Park, HyoJin; Lee, Sang In.

In: World Journal of Gastroenterology, Vol. 18, No. 27, 21.07.2012, p. 3571-3577.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endoscopic and clinicopathologic characteristics of early gastric cancer with high microsatellite instability

AU - Jahng, Jaehoon

AU - Youn, Young Hoon

AU - Kim, Kwang Hyun

AU - Yu, Junghwan

AU - Lee, Yongchan

AU - Hyung, WooJin

AU - Noh, Sung Hoon

AU - Kim, Hyunki

AU - Kim, Hogeun

AU - Park, HyoJin

AU - Lee, Sang In

PY - 2012/7/21

Y1 - 2012/7/21

N2 - AIM: To investigate endoscopic and clinicopathologic characteristics of early gastric cancer (EGC) according to microsatellite instability phenotype. METHODS: Data were retrospectively collected from a single tertiary referral center. Of 981 EGC patients surgically treated between December 2003 and October 2007, 73 consecutive EGC patients with two or more microsatellite instability (MSI) mutation [high MSI (MSI-H)] and 146 consecutive EGC patients with one or no MSI mutation (non-MSI-H) were selected. The endoscopic and clinicopathologic features were compared between the MSI-H and non-MSI-H EGC groups. RESULTS: In terms of endoscopic characteristics, MSI-H EGCs more frequently presented with elevated pattern (OR 4.38, 95% CI: 2.40-8.01, P < 0.001), moderate-to-severe atrophy in the surrounding mucosa (OR 1.91, 95% CI: 1.05-3.47, P = 0.033), antral location (OR 3.99, 95% CI: 2.12-7.52, P < 0.001) and synchronous lesions, compared to non-MSI-H EGCs (OR 2.65, 95% CI: 1.16-6.07, P = 0.021). Other significant clinicopathologic characteristics of MSI-H EGC included predominance of female sex (OR 2.77, 95% CI: 1.53-4.99, P < 0.001), older age (> 70 years) (OR 3.30, 95% CI: 1.57-6.92, P = 0.002), better histologic differentiation (OR 2.35, 95% CI: 1.27-4.34, P = 0.007), intestinal type by Lauren classification (OR 2.34, 95% CI: 1.15-4.76, P = 0.019), absence of a signet ring cell component (OR 2.44, 95% CI: 1.02-5.86, P = 0.046), presence of mucinous component (OR 5.06, 95% CI: 1.27-20.17, P = 0.022), moderate-to-severe lymphoid stromal reaction (OR 3.95, 95% CI: 1.59-9.80, P = 0.003), and co-existing underlying adenoma (OR 2.66, 95% CI: 1.43-4.95, P = 0.002). CONCLUSION: MSI-H EGC is associated with unique endoscopic and clinicopathologic characteristics including frequent presentation in protruded type, co-existing underlying adenoma, and synchronous lesions.

AB - AIM: To investigate endoscopic and clinicopathologic characteristics of early gastric cancer (EGC) according to microsatellite instability phenotype. METHODS: Data were retrospectively collected from a single tertiary referral center. Of 981 EGC patients surgically treated between December 2003 and October 2007, 73 consecutive EGC patients with two or more microsatellite instability (MSI) mutation [high MSI (MSI-H)] and 146 consecutive EGC patients with one or no MSI mutation (non-MSI-H) were selected. The endoscopic and clinicopathologic features were compared between the MSI-H and non-MSI-H EGC groups. RESULTS: In terms of endoscopic characteristics, MSI-H EGCs more frequently presented with elevated pattern (OR 4.38, 95% CI: 2.40-8.01, P < 0.001), moderate-to-severe atrophy in the surrounding mucosa (OR 1.91, 95% CI: 1.05-3.47, P = 0.033), antral location (OR 3.99, 95% CI: 2.12-7.52, P < 0.001) and synchronous lesions, compared to non-MSI-H EGCs (OR 2.65, 95% CI: 1.16-6.07, P = 0.021). Other significant clinicopathologic characteristics of MSI-H EGC included predominance of female sex (OR 2.77, 95% CI: 1.53-4.99, P < 0.001), older age (> 70 years) (OR 3.30, 95% CI: 1.57-6.92, P = 0.002), better histologic differentiation (OR 2.35, 95% CI: 1.27-4.34, P = 0.007), intestinal type by Lauren classification (OR 2.34, 95% CI: 1.15-4.76, P = 0.019), absence of a signet ring cell component (OR 2.44, 95% CI: 1.02-5.86, P = 0.046), presence of mucinous component (OR 5.06, 95% CI: 1.27-20.17, P = 0.022), moderate-to-severe lymphoid stromal reaction (OR 3.95, 95% CI: 1.59-9.80, P = 0.003), and co-existing underlying adenoma (OR 2.66, 95% CI: 1.43-4.95, P = 0.002). CONCLUSION: MSI-H EGC is associated with unique endoscopic and clinicopathologic characteristics including frequent presentation in protruded type, co-existing underlying adenoma, and synchronous lesions.

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