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KMID : 1188320170110060807
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Gut and Liver
2017 Volume.11 No. 6 p.807 ~ p.812
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The Characteristics and Prognosis of Diffuse-Type Early Gastric Cancer Diagnosed during Health Check-Ups
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Lee Ji-Young
Gong Eun-Jeong
Chung Eun-Ju
Park Hye-Won
Bae Suh-Eun
Kim Eun-Hee
Kim Jae-Il
Do Yoon-Suh
Kim Tae-Hyup
Chang Hye-Sook
Song Ho-June
Choe Jae-Won
Jung Hwoon-Yong
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Abstract
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Background/Aims: Because of the poor prognosis of diffuse-type gastric cancer, early detection is important. We investigated the clinical characteristics and prognosis of diffuse-type early gastric cancer (EGC) diagnosed in subjects during health check-ups.
Methods: Among 121,111 subjects who underwent gastroscopy during a routine health check-up, we identified 282 patients with 286 EGC lesions and reviewed their clinical and tumor-specific parameters.
Results: Patients with diffuse-type EGC were younger, and 48.1% of them were female. Serum anti-Helicobacter pylori IgG (Hp-IgG) was positive in 90.7% of diffuse-type EGC patients (vs 75.9% of intestinal-type EGC, p=0.002), and the proportion of diffuse-type EGC cases increased significantly with increasing Hp-IgG serum titers (p<0.001). Diffuse-type EGC had pale discolorations on the tumor surface (26.4% vs 4.0% in intestinal-type EGC, p<0.001) and were often located in the middle third of the stomach. Submucosal invasion or regional nodal metastasis was observed more commonly in patients with diffuse-type EGC. However, during the median follow-up period of 50 months, 5-year disease-free survival rates did not differ between the groups.
Conclusions: Diffuse-type EGC shows different clinical and endoscopic characteristics. Diffuse-type EGC is more closely associated with Hp-IgG seropositivity and a higher serum titer. Early detection results in excellent prognosis.
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KEYWORD
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Stomach neoplasms, Diffuse-type, Early diagnosis, Prognosis, Endoscopy
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