Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers
Background/Aims Predicting histological ulceration in early gastric cancer (EGC) during endoscopic examination is crucial for endoscopists deciding on the treatment modality. The aim of this study was to investigate the endoscopic factors that can predict histological ulcerations in EGCs. Methods We...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Gastrointestinal Endoscopy
2020-05-01
|
| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2019-133.pdf |
| _version_ | 1797642641433690112 |
|---|---|
| author | Jaesin Lee Byung-Wook Kim Cheal Wung Huh Joon Sung Kim Lee-So Maeng |
| author_facet | Jaesin Lee Byung-Wook Kim Cheal Wung Huh Joon Sung Kim Lee-So Maeng |
| author_sort | Jaesin Lee |
| collection | DOAJ |
| description | Background/Aims Predicting histological ulceration in early gastric cancer (EGC) during endoscopic examination is crucial for endoscopists deciding on the treatment modality. The aim of this study was to investigate the endoscopic factors that can predict histological ulcerations in EGCs. Methods We retrospectively analyzed patients who underwent endoscopic submucosal dissection (ESD) for EGC. Clinical features and endoscopic characteristics of EGC such as location, histological differentiation, longest diameter, tumor morphology, mucosal break, converging fold, color change, and surface irregularity were reviewed. Histological ulceration was defined based on ESD specimens. Results A total of 633 EGC lesions from 613 patients were included and histological ulcerations were found in 90 lesions (14.2%). Presence of converging folds, tumor morphology, and color changes on endoscopic examination were related to histological ulceration in the univariate analysis and converging folds along with color changes were statistically significant factors in the multivariate analysis. Kaplan–Meier analysis showed that patients with histological ulcerations in EGCs tended to have higher marginal recurrence rates. Conclusions Mucosal breaks are not equivalent to histological ulcerations. Rather, the existence of converging folds and color changes during endoscopic examination suggest histological ulcerations. Endoscopists should consider these factors when they decide the treatment modality for EGCs. |
| first_indexed | 2024-03-11T14:03:13Z |
| format | Article |
| id | doaj.art-594c75dbcfc24f169cc1743cc12820b5 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T14:03:13Z |
| publishDate | 2020-05-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-594c75dbcfc24f169cc1743cc12820b52023-11-02T03:38:06ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432020-05-0153332833310.5946/ce.2019.1337310Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric CancersJaesin Lee0Byung-Wook Kim1Cheal Wung Huh2Joon Sung Kim3Lee-So Maeng4 Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea Department of Pathology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, KoreaBackground/Aims Predicting histological ulceration in early gastric cancer (EGC) during endoscopic examination is crucial for endoscopists deciding on the treatment modality. The aim of this study was to investigate the endoscopic factors that can predict histological ulcerations in EGCs. Methods We retrospectively analyzed patients who underwent endoscopic submucosal dissection (ESD) for EGC. Clinical features and endoscopic characteristics of EGC such as location, histological differentiation, longest diameter, tumor morphology, mucosal break, converging fold, color change, and surface irregularity were reviewed. Histological ulceration was defined based on ESD specimens. Results A total of 633 EGC lesions from 613 patients were included and histological ulcerations were found in 90 lesions (14.2%). Presence of converging folds, tumor morphology, and color changes on endoscopic examination were related to histological ulceration in the univariate analysis and converging folds along with color changes were statistically significant factors in the multivariate analysis. Kaplan–Meier analysis showed that patients with histological ulcerations in EGCs tended to have higher marginal recurrence rates. Conclusions Mucosal breaks are not equivalent to histological ulcerations. Rather, the existence of converging folds and color changes during endoscopic examination suggest histological ulcerations. Endoscopists should consider these factors when they decide the treatment modality for EGCs.http://www.e-ce.org/upload/pdf/ce-2019-133.pdfearly gastric cancerulcerationendoscopic submucosal dissection |
| spellingShingle | Jaesin Lee Byung-Wook Kim Cheal Wung Huh Joon Sung Kim Lee-So Maeng Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers Clinical Endoscopy early gastric cancer ulceration endoscopic submucosal dissection |
| title | Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers |
| title_full | Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers |
| title_fullStr | Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers |
| title_full_unstemmed | Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers |
| title_short | Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers |
| title_sort | endoscopic factors that can predict histological ulcerations in early gastric cancers |
| topic | early gastric cancer ulceration endoscopic submucosal dissection |
| url | http://www.e-ce.org/upload/pdf/ce-2019-133.pdf |
| work_keys_str_mv | AT jaesinlee endoscopicfactorsthatcanpredicthistologicalulcerationsinearlygastriccancers AT byungwookkim endoscopicfactorsthatcanpredicthistologicalulcerationsinearlygastriccancers AT chealwunghuh endoscopicfactorsthatcanpredicthistologicalulcerationsinearlygastriccancers AT joonsungkim endoscopicfactorsthatcanpredicthistologicalulcerationsinearlygastriccancers AT leesomaeng endoscopicfactorsthatcanpredicthistologicalulcerationsinearlygastriccancers |