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Clinicopathological Features of Advanced Gastric Cancers which Were Misjudged and Subjected to Endoscopic Submucosal Dissection
- Source :
- Gastroenterology Research and Practice, Vol 2020 (2020), Gastroenterology Research and Practice
- Publication Year :
- 2020
- Publisher :
- Hindawi Limited, 2020.
-
Abstract
- Background and Aims. Endoscopic submucosal dissection (ESD) is widely performed for early gastric cancer (EGC). We have sometimes encountered gastric cancer lesions for which ESD was performed and at which pathologically advanced cancer was found. In this study, we performed clinicopathological examination of lesions whose endoscopic diagnosis and pathology differed substantially. Methods. ESD was performed for 2,194 gastric cancer lesions (1,753 cases) in our institute from April 2005 through March 2015. The vertical margin was positive or status unknown in 51 lesions (2.3%); among these, muscularis propria (MP) or deeper infiltration was identified in 6 lesions from specimens obtained during subsequent surgery. In 1 lesion with MP invasion, the vertical margin was negative. We evaluated the clinicopathological features of these 7 lesions and retrospectively reviewed endoscopic indicators of submucosal invasion for EGC on white light imaging (WLI), narrow-band imaging magnifying endoscopy (NBI-ME), and endoscopic ultrasonography (EUS) performed previously. Results. Average age was 73.2±7.2 years, and all cases were men. The 7 lesions diagnosed as advanced cancer were 0.32% of 2,194 lesions and were all located in the U region (fundus). On retrospective review of endoscopic findings, 2 of 7 lesions on WBI, 3 of 6 lesions on NBI-ME, and 2 of 5 lesions on EUS met the criteria for indicating submucosal invasion of EGC. No lesions had findings on all 3 modalities. Conclusion. In rare cases, advanced gastric cancer could not be accurately diagnosed by endoscopy using various modalities. Each case had special characteristics making identification of deep infiltration difficult.
- Subjects :
- medicine.medical_specialty
Article Subject
Hepatology
medicine.diagnostic_test
business.industry
Magnifying endoscopy
Gastroenterology
Endoscopic ultrasonography
Endoscopic submucosal dissection
RC799-869
Diseases of the digestive system. Gastroenterology
Early Gastric Cancer
Endoscopy
Lesion
03 medical and health sciences
0302 clinical medicine
030220 oncology & carcinogenesis
medicine
White light
Clinicopathological features
030211 gastroenterology & hepatology
Radiology
medicine.symptom
business
Research Article
Subjects
Details
- Language :
- English
- ISSN :
- 16876121
- Volume :
- 2020
- Database :
- OpenAIRE
- Journal :
- Gastroenterology Research and Practice
- Accession number :
- edsair.doi.dedup.....3652a241e91b768592abf6183abe75d2