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Endoscopic and clinicopathologic characteristics of early gastric cancer with high microsatellite instability

Authors
 Jaehoon Jahng  ;  Young Hoon Youn  ;  Kwang Hyun Kim  ;  Junghwan Yu  ;  Yong Chan Lee  ;  Woo Jin Hyung  ;  Sung Hoon Noh  ;  Hyunki Kim  ;  Hogeun Kim  ;  Hyojin Park  ;  Sang In Lee 
Citation
 World Journal of Gastroenterology, Vol.18(27) : 3571-3577, 2012 
Journal Title
 World Journal of Gastroenterology 
ISSN
 1007-9327 
Issue Date
2012
Abstract
AIM: To investigate endoscopic and clinicopathologic characteristics of early gastric cancer (EGC) according to microsatellite instability phenotype. METHODS: Data were retrospectively collected from a single tertiary referral center. Of 981 EGC patients surgically treated between December 2003 and October 2007, 73 consecutive EGC patients with two or more microsatellite instability (MSI) mutation [high MSI (MSI-H)] and 146 consecutive EGC patients with one or no MSI mutation (non-MSI-H) were selected. The endoscopic and clinicopathologic features were compared between the MSI-H and non-MSI-H EGC groups. RESULTS: In terms of endoscopic characteristics, MSI-H EGCs more frequently presented with elevated pattern (OR 4.38, 95% CI: 2.40-8.01, P < 0.001), moderate-to-severe atrophy in the surrounding mucosa (OR 1.91, 95% CI: 1.05-3.47, P = 0.033), antral location (OR 3.99, 95% CI: 2.12-7.52, P < 0.001) and synchronous lesions, compared to non-MSI-H EGCs (OR 2.65, 95% CI: 1.16-6.07, P = 0.021). Other significant clinicopathologic characteristics of MSI-H EGC included predominance of female sex (OR 2.77, 95% CI: 1.53-4.99, P < 0.001), older age (> 70 years) (OR 3.30, 95% CI: 1.57-6.92, P = 0.002), better histologic differentiation (OR 2.35, 95% CI: 1.27-4.34, P = 0.007), intestinal type by Lauren classification (OR 2.34, 95% CI: 1.15-4.76, P = 0.019), absence of a signet ring cell component (OR 2.44, 95% CI: 1.02-5.86, P = 0.046), presence of mucinous component (OR 5.06, 95% CI: 1.27-20.17, P = 0.022), moderate-to-severe lymphoid stromal reaction (OR 3.95, 95% CI: 1.59-9.80, P = 0.003), and co-existing underlying adenoma (OR 2.66, 95% CI: 1.43-4.95, P = 0.002). CONCLUSION: MSI-H EGC is associated with unique endoscopic and clinicopathologic characteristics including frequent presentation in protruded type, co-existing underlying adenoma, and synchronous lesions.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92020
DOI
10.3748/wjg.v18.i27.3571
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Biochemistry and Molecular Biology (생화학-분자생물학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
Yonsei Authors
김현기(Kim, Hyunki) ; 김호근(Kim, Ho Keun) ; 노성훈(Noh, Sung Hoon) ; 박효진(Park, Hyo Jin) ; 유정환(You, Jung Whan) ; 윤영훈(Youn, Young Hoon) ; 이상인(Lee, Sang In) ; 이용찬(Lee, Yong Chan) ; 장재훈(Jahng, Jae Hoon) ; 형우진(Hyung, Woo Jin)
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