BACKGROUND: The aim of the present study was to evaluate the clinical importance of the morphology of submucosal tumor invasion and its volume in early gastric cancer. MATERIALS AND METHODS: The subjects were 92 patients with a single lesion of early gastric cancer, who underwent gastrectomy with dissection of lymph nodes, and in whom the lesion was histologically-diagnosed as early gastric cancer with submucosal invasion. The volume of lesions (Vsm, S: < 50 mm3, L: > = 50 mm3) was determined by reconstructing submucosal lesions by the surface rendering method using pathological tissue sections (mean, 3.6 sections/lesion). The relationships between the volume of lesions and lymph node metastasis and between conventional clinicopathological parameters and lymph node metastasis were evaluated. RESULTS: Lymph node metastasis was observed in 18 patients (20%). The depth of submucosal invasion was 1.7 +/- 1.4 mm (mean +/- S.D.; range, 0.2-7.5 mm). sm1 (depth of submucosal tumor invasion < 0.5 mm) was observed in 11 patients (12%), and sm2 (depth of submucosal tumor invasion > = 0.5 mm) in 81 patients (88%). The mean Vsm was 104.1 +/- 215.4 mm3 (0.4-1,730.5 mm3). Fifty-seven patients (62.0%) were in group S, and 35 patients (38.0%) in group L. There was a significant difference between lymph node metastasis and Vsm (S vs. L) alone (p = 0.006). Logistic regression analysis also demonstrated that Vsm alone was correlated with lymph node metastasis (p = 0.005; odds ratio, 1.27; 95% confidence interval, 0.074-0.401). CONCLUSION: The volume of submucosal lesions in early gastric cancer is important for evaluating lymph node metastasis.
BACKGROUND: The aim of the present study was to evaluate the clinical importance of the morphology of submucosal tumor invasion and its volume in early gastric cancer. MATERIALS AND METHODS: The subjects were 92 patients with a single lesion of early gastric cancer, who underwent gastrectomy with dissection of lymph nodes, and in whom the lesion was histologically-diagnosed as early gastric cancer with submucosal invasion. The volume of lesions (Vsm, S: < 50 mm3, L: > = 50 mm3) was determined by reconstructing submucosal lesions by the surface rendering method using pathological tissue sections (mean, 3.6 sections/lesion). The relationships between the volume of lesions and lymph node metastasis and between conventional clinicopathological parameters and lymph node metastasis were evaluated. RESULTS: Lymph node metastasis was observed in 18 patients (20%). The depth of submucosal invasion was 1.7 +/- 1.4 mm (mean +/- S.D.; range, 0.2-7.5 mm). sm1 (depth of submucosal tumor invasion < 0.5 mm) was observed in 11 patients (12%), and sm2 (depth of submucosal tumor invasion > = 0.5 mm) in 81 patients (88%). The mean Vsm was 104.1 +/- 215.4 mm3 (0.4-1,730.5 mm3). Fifty-seven patients (62.0%) were in group S, and 35 patients (38.0%) in group L. There was a significant difference between lymph node metastasis and Vsm (S vs. L) alone (p = 0.006). Logistic regression analysis also demonstrated that Vsm alone was correlated with lymph node metastasis (p = 0.005; odds ratio, 1.27; 95% confidence interval, 0.074-0.401). CONCLUSION: The volume of submucosal lesions in early gastric cancer is important for evaluating lymph node metastasis.
Authors: Yoo Jin Um; Hae Won Kim; Da Hyun Jung; Jie-Hyun Kim; Jae Jun Park; Young Hoon Youn; Hyojin Park; Jong Won Kim; Seung Ho Choi; Sung Hoon Noh Journal: PLoS One Date: 2017-12-20 Impact factor: 3.240