The implications of Endoscopic ulcer in early gastric cancer: Can we predict clinical behaviors from Endoscopy?

Yoo Jin Lee, Jie Hyun Kim, Jae Jun Park, Young Hoon Youn, Hyojin Park, Jong Won Kim, Seung Ho Choi, Sung Hoon Noh

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: The presence of ulcer in early gastric cancer (EGC) is important for the feasibility of endoscopic resection, only a few studies have examined the clinicopathological implications of endoscopic ulcer in EGC. Objectives: To determine the role of endoscopic ulcer as a predictor of clinical behaviors in EGC. Methods: Data of 3,270 patients with EGC who underwent surgery between January 2005 and December 2012 were reviewed. Clinicopathological characteristics were analyzed in relation to the presence and stage of ulcer in EGC. Based on endoscopic findings, the stage of ulcer was categorized as active, healing, or scar. Logistic regression analysis was performed to analyze factors associated with lymph node metastasis (LNM). Results: 2,343 (71.7%) patients had endoscopic findings of ulceration in EGC. Submucosal (SM) invasion, LNM, lymphovascular invasion (LVI), perineural invasion, and undifferentiatedtype histology were significantly higher in ulcerative than non-ulcerative EGC. Comparison across different stages of ulcer revealed that SM invasion, LNM, and LVI were significantly associated with the active stage, and that these features exhibited significant stage-based differences, being most common at the active stage, and least common at the scar stage. The presence of endoscopic ulcer and active status of the ulcer were identified as independent risk factors for LNM. Conclusions: Ulcerative EGC detected by endoscopy exhibited more aggressive behaviors than nonulcerative EGC. Additionally, the endoscopic stage of ulcer may predict the clinicopathological behaviors of EGC. Therefore, the appearance of ulcers should be carefully evaluated to determine an adequate treatment strategy for EGC.

Original languageEnglish
Article number164339
JournalPloS one
Volume11
Issue number10
DOIs
Publication statusPublished - 2016 Oct

Fingerprint

Histology
Endoscopy
stomach neoplasms
endoscopy
Regression analysis
Surgery
Ulcer
Stomach Neoplasms
Logistics
metastasis
lymph nodes
Lymph Nodes
Neoplasm Metastasis
Cicatrix
resection
histology
Statistical Factor Analysis
aggression
regression analysis
risk factors

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lee, Yoo Jin ; Kim, Jie Hyun ; Park, Jae Jun ; Youn, Young Hoon ; Park, Hyojin ; Kim, Jong Won ; Choi, Seung Ho ; Noh, Sung Hoon. / The implications of Endoscopic ulcer in early gastric cancer : Can we predict clinical behaviors from Endoscopy?. In: PloS one. 2016 ; Vol. 11, No. 10.
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abstract = "Background: The presence of ulcer in early gastric cancer (EGC) is important for the feasibility of endoscopic resection, only a few studies have examined the clinicopathological implications of endoscopic ulcer in EGC. Objectives: To determine the role of endoscopic ulcer as a predictor of clinical behaviors in EGC. Methods: Data of 3,270 patients with EGC who underwent surgery between January 2005 and December 2012 were reviewed. Clinicopathological characteristics were analyzed in relation to the presence and stage of ulcer in EGC. Based on endoscopic findings, the stage of ulcer was categorized as active, healing, or scar. Logistic regression analysis was performed to analyze factors associated with lymph node metastasis (LNM). Results: 2,343 (71.7{\%}) patients had endoscopic findings of ulceration in EGC. Submucosal (SM) invasion, LNM, lymphovascular invasion (LVI), perineural invasion, and undifferentiatedtype histology were significantly higher in ulcerative than non-ulcerative EGC. Comparison across different stages of ulcer revealed that SM invasion, LNM, and LVI were significantly associated with the active stage, and that these features exhibited significant stage-based differences, being most common at the active stage, and least common at the scar stage. The presence of endoscopic ulcer and active status of the ulcer were identified as independent risk factors for LNM. Conclusions: Ulcerative EGC detected by endoscopy exhibited more aggressive behaviors than nonulcerative EGC. Additionally, the endoscopic stage of ulcer may predict the clinicopathological behaviors of EGC. Therefore, the appearance of ulcers should be carefully evaluated to determine an adequate treatment strategy for EGC.",
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The implications of Endoscopic ulcer in early gastric cancer : Can we predict clinical behaviors from Endoscopy? / Lee, Yoo Jin; Kim, Jie Hyun; Park, Jae Jun; Youn, Young Hoon; Park, Hyojin; Kim, Jong Won; Choi, Seung Ho; Noh, Sung Hoon.

In: PloS one, Vol. 11, No. 10, 164339, 10.2016.

Research output: Contribution to journalArticle

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T1 - The implications of Endoscopic ulcer in early gastric cancer

T2 - Can we predict clinical behaviors from Endoscopy?

AU - Lee, Yoo Jin

AU - Kim, Jie Hyun

AU - Park, Jae Jun

AU - Youn, Young Hoon

AU - Park, Hyojin

AU - Kim, Jong Won

AU - Choi, Seung Ho

AU - Noh, Sung Hoon

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AB - Background: The presence of ulcer in early gastric cancer (EGC) is important for the feasibility of endoscopic resection, only a few studies have examined the clinicopathological implications of endoscopic ulcer in EGC. Objectives: To determine the role of endoscopic ulcer as a predictor of clinical behaviors in EGC. Methods: Data of 3,270 patients with EGC who underwent surgery between January 2005 and December 2012 were reviewed. Clinicopathological characteristics were analyzed in relation to the presence and stage of ulcer in EGC. Based on endoscopic findings, the stage of ulcer was categorized as active, healing, or scar. Logistic regression analysis was performed to analyze factors associated with lymph node metastasis (LNM). Results: 2,343 (71.7%) patients had endoscopic findings of ulceration in EGC. Submucosal (SM) invasion, LNM, lymphovascular invasion (LVI), perineural invasion, and undifferentiatedtype histology were significantly higher in ulcerative than non-ulcerative EGC. Comparison across different stages of ulcer revealed that SM invasion, LNM, and LVI were significantly associated with the active stage, and that these features exhibited significant stage-based differences, being most common at the active stage, and least common at the scar stage. The presence of endoscopic ulcer and active status of the ulcer were identified as independent risk factors for LNM. Conclusions: Ulcerative EGC detected by endoscopy exhibited more aggressive behaviors than nonulcerative EGC. Additionally, the endoscopic stage of ulcer may predict the clinicopathological behaviors of EGC. Therefore, the appearance of ulcers should be carefully evaluated to determine an adequate treatment strategy for EGC.

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