Growth patterns of signet ring cell carcinoma of the stomach for endoscopic resection

Hyunki Kim, Jie Hyun Kim, Yong Chan Lee, Hoguen Kim, Young Hoon Youn, Hyojin Park, Seung Ho Choi, Sung Hoon Noh, Takuji Gotoda

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background/Aims: It is difficult to precisely detect the lateral margin during endoscopic submucosal dissection (ESD) for signet ring cell carcinoma (SRC) because SRC often expands to lateral direction through the lamina propria. Thus, the aim of this study was to classify the intramucosal spreading patterns of SRC and to analyze the patients' clinicopathological findings according to the spreading patterns. Methods: The intramucosal spreading patterns of SRC were classified as expansive or infiltrative types. A total of 100 surgical and 42 ESD specimens were reviewed. Results: In the surgical specimens, the proportions of expansive and infiltrative types were 44% and 56%, respectively. The infiltrative type was more commonly associated with old age, atrophy, and intestinal metaplasia in surrounding mucosa and the absence of Helicobacter pylori compared with the expansive type. In ESD specimens, the proportions of expansive and in-filtrative types were each 50%. When lateral margin-positive lesions were compared with -negative lesions, larger size, residual lesion, and the lack of a neutrophil infiltration were more significantly associated with lateral margin-positive lesions. All cases with residual tumors in lateral margin-positive lesions were classified as the infiltrative type. Conclusions: SRC surrounded with atrophy and/or intestinal metaplasia often spreads subepithelially in the margin. This finding may suggest that a larger safety margin is necessary in this type during ESD.

Original languageEnglish
Pages (from-to)720-726
Number of pages7
JournalGut and liver
Volume9
Issue number6
DOIs
Publication statusPublished - 2015 Nov

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Signet Ring Cell Carcinoma
Stomach
Growth
Metaplasia
Atrophy
Mucous Membrane
Neutrophil Infiltration
Residual Neoplasm
Helicobacter pylori
Safety
Endoscopic Mucosal Resection

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Kim, Hyunki ; Kim, Jie Hyun ; Lee, Yong Chan ; Kim, Hoguen ; Youn, Young Hoon ; Park, Hyojin ; Choi, Seung Ho ; Noh, Sung Hoon ; Gotoda, Takuji. / Growth patterns of signet ring cell carcinoma of the stomach for endoscopic resection. In: Gut and liver. 2015 ; Vol. 9, No. 6. pp. 720-726.
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abstract = "Background/Aims: It is difficult to precisely detect the lateral margin during endoscopic submucosal dissection (ESD) for signet ring cell carcinoma (SRC) because SRC often expands to lateral direction through the lamina propria. Thus, the aim of this study was to classify the intramucosal spreading patterns of SRC and to analyze the patients' clinicopathological findings according to the spreading patterns. Methods: The intramucosal spreading patterns of SRC were classified as expansive or infiltrative types. A total of 100 surgical and 42 ESD specimens were reviewed. Results: In the surgical specimens, the proportions of expansive and infiltrative types were 44{\%} and 56{\%}, respectively. The infiltrative type was more commonly associated with old age, atrophy, and intestinal metaplasia in surrounding mucosa and the absence of Helicobacter pylori compared with the expansive type. In ESD specimens, the proportions of expansive and in-filtrative types were each 50{\%}. When lateral margin-positive lesions were compared with -negative lesions, larger size, residual lesion, and the lack of a neutrophil infiltration were more significantly associated with lateral margin-positive lesions. All cases with residual tumors in lateral margin-positive lesions were classified as the infiltrative type. Conclusions: SRC surrounded with atrophy and/or intestinal metaplasia often spreads subepithelially in the margin. This finding may suggest that a larger safety margin is necessary in this type during ESD.",
author = "Hyunki Kim and Kim, {Jie Hyun} and Lee, {Yong Chan} and Hoguen Kim and Youn, {Young Hoon} and Hyojin Park and Choi, {Seung Ho} and Noh, {Sung Hoon} and Takuji Gotoda",
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Growth patterns of signet ring cell carcinoma of the stomach for endoscopic resection. / Kim, Hyunki; Kim, Jie Hyun; Lee, Yong Chan; Kim, Hoguen; Youn, Young Hoon; Park, Hyojin; Choi, Seung Ho; Noh, Sung Hoon; Gotoda, Takuji.

In: Gut and liver, Vol. 9, No. 6, 11.2015, p. 720-726.

Research output: Contribution to journalArticle

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T1 - Growth patterns of signet ring cell carcinoma of the stomach for endoscopic resection

AU - Kim, Hyunki

AU - Kim, Jie Hyun

AU - Lee, Yong Chan

AU - Kim, Hoguen

AU - Youn, Young Hoon

AU - Park, Hyojin

AU - Choi, Seung Ho

AU - Noh, Sung Hoon

AU - Gotoda, Takuji

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N2 - Background/Aims: It is difficult to precisely detect the lateral margin during endoscopic submucosal dissection (ESD) for signet ring cell carcinoma (SRC) because SRC often expands to lateral direction through the lamina propria. Thus, the aim of this study was to classify the intramucosal spreading patterns of SRC and to analyze the patients' clinicopathological findings according to the spreading patterns. Methods: The intramucosal spreading patterns of SRC were classified as expansive or infiltrative types. A total of 100 surgical and 42 ESD specimens were reviewed. Results: In the surgical specimens, the proportions of expansive and infiltrative types were 44% and 56%, respectively. The infiltrative type was more commonly associated with old age, atrophy, and intestinal metaplasia in surrounding mucosa and the absence of Helicobacter pylori compared with the expansive type. In ESD specimens, the proportions of expansive and in-filtrative types were each 50%. When lateral margin-positive lesions were compared with -negative lesions, larger size, residual lesion, and the lack of a neutrophil infiltration were more significantly associated with lateral margin-positive lesions. All cases with residual tumors in lateral margin-positive lesions were classified as the infiltrative type. Conclusions: SRC surrounded with atrophy and/or intestinal metaplasia often spreads subepithelially in the margin. This finding may suggest that a larger safety margin is necessary in this type during ESD.

AB - Background/Aims: It is difficult to precisely detect the lateral margin during endoscopic submucosal dissection (ESD) for signet ring cell carcinoma (SRC) because SRC often expands to lateral direction through the lamina propria. Thus, the aim of this study was to classify the intramucosal spreading patterns of SRC and to analyze the patients' clinicopathological findings according to the spreading patterns. Methods: The intramucosal spreading patterns of SRC were classified as expansive or infiltrative types. A total of 100 surgical and 42 ESD specimens were reviewed. Results: In the surgical specimens, the proportions of expansive and infiltrative types were 44% and 56%, respectively. The infiltrative type was more commonly associated with old age, atrophy, and intestinal metaplasia in surrounding mucosa and the absence of Helicobacter pylori compared with the expansive type. In ESD specimens, the proportions of expansive and in-filtrative types were each 50%. When lateral margin-positive lesions were compared with -negative lesions, larger size, residual lesion, and the lack of a neutrophil infiltration were more significantly associated with lateral margin-positive lesions. All cases with residual tumors in lateral margin-positive lesions were classified as the infiltrative type. Conclusions: SRC surrounded with atrophy and/or intestinal metaplasia often spreads subepithelially in the margin. This finding may suggest that a larger safety margin is necessary in this type during ESD.

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