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KMID : 0931320150150030166
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대한상부위장관.헬리코박터학회지
2015 Volume.15 No. 3 p.166 ~ p.173
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Variable Endoscopic Findings and Clinicopathological Characteristics of Borrmann Type 4 Advanced Gastric Cancer
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장지영:Chang Ji-Young
심기남:Shim Ki-Nam/태정현:Tae Chung-Hyun/최아름:Choe A-Reum/문창모:Moon Chang-Mo/김성은:Kim Seong-Eun/정혜경:Jung Hye-Kyung/정성애:Jung Sung-Ae
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Abstract
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Background/Aims: Borrmann type 4 advanced gastric cancer (AGC) is difficult to diagnose. There are no typical endoscopic findings. Endoscopic biopsies have a high false negative rate because Borrmann type 4 AGC frequently resides below the submucosal cells from which it develops. The aim of this study was to investigate the endoscopic findings of Borrmann type 4 AGC in order to improve diagnosis rates.
Materials and Methods: A total of 24 patients with pathologically proven Borrmann type 4 AGC at the Ewha Womans University Medical Center between January 2008 and May 2013 were included. We divided the cases according to their distinguishing endoscopic findings. The diagnostic yield for endoscopic biopsies was evaluated.
Results: The most common endoscopic findings were cases with Bormann type 4 AGC like lesions (diffuse infiltrative, n=10), followed by Bormann type 3 AGC like lesions (ulceroinfiltrative, n=9), Borrmann type 2 AGC like lesions (ulcerofungating, n=4) and early gastric cancer like lesion (n=1). Among the 23 cases in which endoscopic biopsies was performed, the diagnostic yield for the first endoscopic biopsy was 87.0% (n=20). All of the second endoscopic biopsies failed to diagnose the malignancy.
Conclusions: The endoscopic findings of Borrmann type 4 AGC are atypical and diverse. In cases where negative results are accompanied by a malignant impression, further meticulous evaluation should be performed with careful targeting.
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KEYWORD
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Stomach neoplasms, Endoscopy, gastrointestinal
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