Risk factors for depth of infiltration in the differentiated depressed early gastric carcinoma: a preliminary analysis.

Shu-Dong Yang,Guo-Min Lu,Qiang Zhan,Zhi-Xin Qian,Qun-Yan Zhou

doi:10.1186/s13000-014-0206-8

Abstract

BackgroundTo analyze the clinicopathologic factors associated with mucosal and submucosal infiltration in differentiated depressed early gastric cancer, and screening factors that can predict depth of infiltration before endoscopic treatment.MethodsThe study included 35 cases of mucosal carcinomas and 66 cases of submucosal carcinomas according to the pathological diagnosis. The relevant clinicopathologic factors were investigated by univariate and multivariate analysis.ResultsThe average depth of the depressed lesions for the submucosal group was significantly more than that for the mucosal group. The proportion of the lesions with rough bottom surface and abnormal surrounding folds was significantly higher in the submucosal group compared to that in the mucosal group. Logistic regression analysis indicated that the above-mentioned three factors were independent risk factors that could be used to predict mucosal and submucosal infiltration. Area under the curve (AUC) of receiver operating characteristic (ROC) of the ordinal above-mentioned three factors for predicting submucosal infiltration was 0.716, 0.663, 0.704, respectively. Stratified analysis showed that the 100% cases with lesion depth ≥2.5 mm and rough bottom surface developed submucosal infiltration regardless of the morphological changes of the folds.ConclusionThe study identified independent risk factors for predicting mucosal and submucosal infiltration in depressed differentiated early gastric cancer, which may evaluate the degree of penetration before endoscopic treatment.Virtual SlidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/13000_2014_206

Highlights

To analyze the clinicopathologic factors associated with mucosal and submucosal infiltration in differentiated depressed early gastric cancer, and screening factors that can predict depth of infiltration before endoscopic treatment
Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are therapeutic endoscopic techniques that offer the advantage of acquiring specimens from the lesion for pathological analysis
T test or Wilcoxon rank test were used to process quantitative data, and categorical data were processed by chi-square test

Summary

Introduction

To analyze the clinicopathologic factors associated with mucosal and submucosal infiltration in differentiated depressed early gastric cancer, and screening factors that can predict depth of infiltration before endoscopic treatment. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) have become one of the standard treatment methods for early-stage gastric cancer in Japan. The development of these two endoscopic technologies has benefited from research on two screening criteria for operability for endoscopic resection. EMR and ESD are therapeutic endoscopic techniques that offer the advantage of acquiring specimens from the lesion for pathological analysis. These have become the most accurate approaches for the diagnosis of early gastric cancer. The disease-specific 5- and 10-year survival rates can reach 99% for patients who meet the above evaluation criteria for EMR treatment of early gastric cancer before surgery [3]

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