Location characteristics of gastric low-grade, high-grade dysplasia and early cancer for endoscopic diagnosis

Background: Revealing out the hot zone and feature of early gastric cancers (EGCs) and dysplasia frequently developed is important for endoscopic screening and surveillance. This study aimed to investigate the distribution and location characteristics of EGCs and dysplasia. Methods: A total of 503 pathological diagnosed EGCs and dysplasia from 445 patients were reviewed retrospectively. The distribution of EGCs and dysplasia in stomach was mapped, and its associated clinicopathological findings were analyzed. Results: EGCs and dysplasia were predominately in the lesser curvature transversely, and vertical distributed frequently in lower third (51.7%) of stomach. In addition, lesions in upper third is associated with older age (p ​= ​0.014), male sex (p ​= ​0.002), smaller size (p < 0.001) and more differentiated EGCs, but fewer low-grade dysplasia and undifferentiated EGCs (p < 0.001). Moreover, most (461/503, 91.7%) lesions were found in endoscopy diagnosed atrophic mucosa, and are predominately differentiated EGCs and dysplasia (384/461, 83.3%). For the lesions in endoscopy diagnosed non-atrophic mucosa, more than half (23/42, 54.8%) are undifferentiated EGCs, which predominantly in middle (52.2%) and lower third (39.1%) of stomach. Whereas, differentiated EGCs accounts for 23.8% (10/42), and mainly (90%) located in the upper third of the stomach. Conclusions: The distribution of dysplasia, differentiated and undifferentiated EGCs was associated to location and atrophic mucosa. Those location characteristics are useful for endoscopic screening and surveillance.