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Clinical implication of endoscopic gross appearance in early gastric cancer: revisited

 Da Hyun Jung  ;  Yoo Mi Park  ;  Jie-Hyun Kim  ;  Yong Chan Lee  ;  Young Hoon Youn  ;  Hyojin Park  ;  Sang In Lee  ;  Jong Won Kim  ;  Seung Ho Choi  ;  Woo Jin Hyung  ;  Sung Hoon Noh 
 Surgical Endoscopy , Vol.27(10) : 3690-3695, 2013 
Journal Title
 Surgical Endoscopy  
Issue Date
BACKGROUND: The macroscopic appearance of early gastric cancer (EGC) is known to reflect its growth patterns. The purpose of this study was to investigate the role of the endoscopic appearance as a predictor of clinical behavior in EGC. METHODS: Between January 2005 and December 2008, 1,845 patients were diagnosed with EGC and underwent surgery. The clinicopathologic characteristics were retrospectively analyzed according to gross appearance. Endoscopic findings were classified by predominant type as elevated, flat, or depressed. Flat and depressed types were categorized together as nonelevated type. RESULTS: The proportions of elevated, flat, and depressed types were 16.6, 28.6, and 54.8 %. The gross appearance of the elevated type predominantly showed well/moderate differentiation, whereas the flat and depressed types showed signet-ring cells and poor differentiation, respectively. When the elevated and nonelevated types were compared, submucosal invasion, lymphovascular invasion (LVI), and lymph-node metastasis (LNM) were higher in elevated than in nonelevated type. In differentiated EGC, submucosal invasion, LVI, LNM, and multiplicity were significantly higher in the elevated than the nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. In undifferentiated EGC, submucosal invasion, LVI, and perineural invasion were significantly higher in elevated than in nonelevated type. These patterns were significantly common in the order elevated, depressed, and flat types. However, LNM was not significantly different based on gross appearance in undifferentiated EGC. CONCLUSIONS: Clinical behavior differs according to endoscopic appearance in EGC. The endoscopic appearance of EGC may facilitate prediction of clinical behavior, particularly in differentiated 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
Yonsei Authors
김종원(Kim, Jong Won)
김지현(Kim, Jie-Hyun) ORCID logo https://orcid.org/0000-0002-9198-3326
노성훈(Noh, Sung Hoon) ORCID logo https://orcid.org/0000-0003-4386-6886
박유미(Park, Yoo Mi) ORCID logo https://orcid.org/0000-0002-3642-7300
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
이용찬(Lee, Yong Chan)
정다현(Jung, Da Hyun)
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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