The incidence of the gastric cancer is the highest among the all malignant neoplasm in Korean, and its prognosis and survival rate are poor as yet. However, the prognosis of the early gastric cancer(EGC) is very good.
It is reported that the over all 5 year survival rate of GEC is over 90% in comparsion to the 15% of advanced cancer. So early diagnosis and operation on the gastric cancer is very improtant to increase the better prognis and prologh the survival
rate.
Recently double-contrast upper G-I series and fiberoptic gastroendoscopy with biopsy performed as a routine screening study which increased the detection rate of EGC. In case of the EGC, the depth of tumor invasion and regional lymph node
metastasis are
important factor in its prognosis.
In the present study, 104 cases of EGC which were comfirmed by gastrectomy and histopathological examination during the period of 10 years from 1983 to 1992 at Department of Surgery, Chosum University Hospital was performed retrospectively to
evaluate
the prognostic factor.
@ES The obtained results were as follow;
@EN 1) The incidence of EGC in gastric cancer was 10.6%. The overall male to female sex ratio was 1.67 : 1 and peak incidence of age was 5th decades(36 cases, 34.6%).
2) The preoperative diagnostic rate was 69.0% by double constrast X-Ray and 81.6% by endoscopy with biopsy.
3) The common sites were lower third and lesser curvature, and the size of tumor was variable, 68 cases were less than 3 cm in dimeter. But the size of lesion could not effect the frequency of lymph node metastasis.
4) Ratio of EGC limited to mucosa to that of submucosal involvement was 1 : 1.6, and proportion of EGC according to macroscopic classification was 15.4% of elevated type, 3.8% of flat type and 80.8% of depressed type. The most common type of
lesion was
IIc(48.1%) and its combined type(26.0%)
5) The rate of lymphnode metstasis according to the depth of invasion was 2.9%(3 cases) in mucosa, 11.5%(12cases) in submucosa and 14.4%(15cases) in total case. And there was stastically significant difference in frequency of nodal metastasis
according
to the depth of invasion(P<0.01).
6) The frequency of nodal metastasis according to macroscopic classification was 7 cases of IIc type, 4 cases of IIc+III type, and 2 cases of III type, and 2 cases of III type. So depressed type had more lymphnode metastasis than elevated. Flat
type.
7) In the histological classification the most common type of the EGC was moderate differentiation(32.7%), the rate of lymphnode metastasis according to cell differentiation was 21.7% in poorly differentiated type and 16.7% in signet ring cell,
but
there was no significant difference in frequency of nodal metastasis according to neoplastic cellular differentiation.
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