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Are new criteria for mixed histology necessary for endoscopic resection in early gastric cancer?

 Hong Jin Yoon  ;  Yong Hoon Kim  ;  Jie-Hyun Kim  ;  HyunKi Kim  ;  Hoguen Kimb  ;  Jae Jun Park  ;  Young Hoon Youn  ;  Hyojin Park  ;  Jong Won Kim  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Seung Ho Choi 
 Pathology Research and Practice, Vol.212(5) : 410-414, 2016 
Journal Title
 Pathology Research and Practice 
Issue Date
Aged ; Aged, 80 and over ; Carcinoma, Signet Ring Cell/pathology* ; Carcinoma, Signet Ring Cell/surgery ; Early Detection of Cancer ; Female ; Gastrectomy* ; Gastroscopy* ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery
Early gastric cancer ; Endoscopic resection ; Lymph node metastasis ; Mixed histology
PURPOSE: Early gastric cancer (EGC) of mixed histology is more aggressive than other histologies. In addition, signet ring cell (SRC) mixed histology shows more submucosal invasion and greater lymph node metastasis (LNM). However, there are no criteria for endoscopic resection (ER) in mixed histology. Therefore, this study investigated whether new criteria for mixed histology are necessary for ER in EGC. METHODS: From January 2005 to December 2012, 3419 patients with EGC underwent surgery. Lesions were classified using three histological classifications: the Japanese classification; World Health Organization (WHO) classification including SRC mixed histology; and Lauren classification. The mixed type in the Lauren classification was also reclassified according to the proportion of differentiated and undifferentiated components. Clinicopathological characteristics were compared according to histological classifications, with special reference to the ER criteria. RESULTS: With the Lauren classification, 179 (5.3%) lesions were classified as mixed type, including 54 (30.2%) lesions as the differentiated-predominant mixed type. There were 361 (10.6%) lesions classified as SRC mixed histology. Mixed-type lesions in the Lauren classification and SRC mixed lesions were significantly associated with larger size and a greater LNM. Among the lesions meeting the ER criteria, 20 (1.6%) and 55 (4.7%) were categorized as mixed type by the Lauren classification and SRC mixed histology, respectively. However, there was no LNM among the lesions recategorized into mixed histology. CONCLUSIONS: Mixed histology showed no LNM among the lesions met the present ER criteria. Thus, separate criteria for mixed histology might be not necessary in the criteria for ER in EGC
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
김용훈(Kim, Yong Hoon)
김종원(Kim, Jong Won)
김지현(Kim, Jie-Hyun) ORCID logo https://orcid.org/0000-0002-9198-3326
김현기(Kim, Hyunki) ORCID logo https://orcid.org/0000-0003-2292-5584
김호근(Kim, Ho Keun)
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
박재준(Park, Jae Jun)
박효진(Park, Hyo Jin) ORCID logo https://orcid.org/0000-0003-4814-8330
윤영훈(Youn, Young Hoon) ORCID logo https://orcid.org/0000-0002-0071-229X
윤홍진(Yoon, Hong Jin)
최승호(Choi, Seung Ho) ORCID logo https://orcid.org/0000-0002-9872-3594
형우진(Hyung, Woo Jin) ORCID logo https://orcid.org/0000-0002-8593-9214
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