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Undifferentiated early gastric cancer diagnosed as differentiated histology based on forceps biopsy.
MedLine Citation:
PMID:  23598070     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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.
Authors:
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
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-3-15
Journal Detail:
Title:  Pathology, research and practice     Volume:  -     ISSN:  1618-0631     ISO Abbreviation:  Pathol. Res. Pract.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-4-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806109     Medline TA:  Pathol Res Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Elsevier GmbH. All rights reserved.
Affiliation:
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea.
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