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The Implications of Endoscopic Ulcer in Early Gastric Cancer: Can We Predict Clinical Behaviors from Endoscopy?

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Author(s)
Yoo Jin LeeJie-Hyun KimJae Jun ParkYoung Hoon YounHyojin ParkJong Won KimSeung Ho ChoiSung Hoon Noh
Keimyung Author(s)
Lee, Yoo Jin
Department
Dept. of Internal Medicine (내과학)
Journal Title
PloS One
Issued Date
2016
Volume
11
Issue
10
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 undifferentiated-type 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 non-ulcerative 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.
Keimyung Author(s)(Kor)
이유진
Publisher
School of Medicine
Citation
Yoo Jin Lee et al. (2016). The Implications of Endoscopic Ulcer in Early Gastric Cancer: Can We Predict Clinical Behaviors from Endoscopy? PloS One, 11(10), e0164339–e0164339. doi: 10.1371/journal.pone.0164339
Type
Article
ISSN
1932-6203
DOI
10.1371/journal.pone.0164339
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32555
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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