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Undifferentiated early gastric cancer diagnosed as differentiated histology based on forceps biopsy

 Jung Ho Lee  ;  Jie-Hyun Kim  ;  Kwangwon Rhee  ;  Cheal Wung Huh  ;  Yong Chan Lee  ;  Sun Och Yoon  ;  Young Hoon Youn  ;  Hyojin Park  ;  Sang In Lee 
 PATHOLOGY RESEARCH AND PRACTICE, Vol.209(5) : 314-318, 2013 
Journal Title
Issue Date
Adenocarcinoma/epidemiology ; Adenocarcinoma/pathology* ; Adenocarcinoma/surgery ; Aged ; Biopsy ; Early Diagnosis* ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Stomach Neoplasms/epidemiology ; Stomach Neoplasms/pathology* ; Stomach Neoplasms/surgery
Endoscopic resection ; Early gastric cancer ; Undifferentiated cancer ; Biopsy
Histological diagnosis before endoscopic resection (ER) is important to determine whether ER should be performed; indeed, the use of ER for undifferentiated early gastric cancer (UD-EGC) remains controversial. The aim was to investigate the clinicopathological features of UD-EGC in ER specimens, diagnosed as differentiated histology based on biopsy. 289 patients with EGC were treated by ER. Among them, 13.1% were diagnosed as UD-EGC after ER, and 18.4% of them showed differentiated histology based on biopsy before ER. We analyzed UD-EGC with differentiated histology (D-group) compared to undifferentiated histology (UD-group) on biopsy. The D-group showed moderately differentiated adenocarcinoma on biopsy and poorly differentiated adenocarcinoma in ER specimens. The D-group was significantly associated with older age, intestinal metaplasia in the surrounding mucosa, and larger size than the UD-group. Gland portion of tumor, mixed-type Lauren classification, submucosal invasion, lymphovascular invasion, and perineural invasion were more common in the D-group than in the UD-group. The number of biopsies was not different between the groups. When comparing the histopathological mapping findings and endoscopic appearances of the D-group, the zone of transition from differentiated to undifferentiated histology was frequently found on one or two peripheral sides of the lesion. In conclusion, areas of EGC greater than 20mm with moderately differentiated histology on biopsy may contain an undifferentiated component. UD-EGC with differentiated histology on biopsy may show more aggressive behavior than UD-EGC, consistent with the biopsy pathology. Biopsy at several peripheral sides of the lesion may be helpful for diagnosis of UD histology before treatment.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jie-Hyun(김지현) ORCID logo https://orcid.org/0000-0002-9198-3326
Park, Hyo Jin(박효진) ORCID logo https://orcid.org/0000-0003-4814-8330
Yoon, Sun Och(윤선옥) ORCID logo https://orcid.org/0000-0002-5115-1402
Youn, Young Hoon(윤영훈) ORCID logo https://orcid.org/0000-0002-0071-229X
Rhee, Kwang Won(이광원)
Lee, Yong Chan(이용찬) ORCID logo https://orcid.org/0000-0001-8800-6906
Lee, Jung Ho(이정호)
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