Fujiwara Shozo, Noguchi Tsuyoshi, Noguchi Takuya, Aizawa Tetsuya, Matsunaga Mototsugu, Moriyama Hatsuo
Department of Gastrointestinal Surgery, Oita University Hospital, Oita, Japan.
Hepatogastroenterology. 2012 May;59(115):951-4. doi: 10.5754/hge10522.
BACKGROUND/AIMS: It remains unclear whether synchronous, multiple, early gastric cancers can be radically resected with endoscopic resection.
Patients who underwent gastrectomy for early gastric cancer were included in this study and divided into two groups: a solitary gastric cancer group and a multiple gastric cancer group. The clinicopathological features of patients in each group were compared and the criteria for endoscopic resection were subsequently investigated.
A total of 244 patients were included in the present study. The solitary and multiple gastric cancer groups included 228 patients (93.4%) and 16 patients (6.6%), respectively. The multiple gastric cancer group included 35 lesions, including a greater number of larger tumors and protruded- type tumors, as well as increased incidence of submucosal and lymphatic invasion. Only 2 of 16 cases (12.5%) in the multiple gastric cancer group met the criteria for endoscopic resection. Eleven cases were excluded due to submucosal invasion and three cases were excluded due to undifferentiated histopathological type tumors.
To be suitable for radical endoscopic resection, prompt detection of early gastric cancer is essential, before they become multiple gastric cancers and invade the submucosa.
背景/目的:同步性多发早期胃癌能否通过内镜切除术进行根治性切除仍不明确。
本研究纳入接受早期胃癌胃切除术的患者,并分为两组:单发胃癌组和多发胃癌组。比较每组患者的临床病理特征,随后研究内镜切除的标准。
本研究共纳入244例患者。单发和多发胃癌组分别有228例(93.4%)和16例(6.6%)。多发胃癌组包括35个病灶,其中较大肿瘤和隆起型肿瘤数量较多,黏膜下层和淋巴管侵犯的发生率也增加。多发胃癌组16例中仅2例(12.5%)符合内镜切除标准。11例因黏膜下层侵犯被排除,3例因组织病理学类型为未分化肿瘤被排除。
为适合进行根治性内镜切除,在早期胃癌发展为多发胃癌并侵犯黏膜下层之前及时检测至关重要。