Jung Ji Hoon, Choi Kee Don, Koh Young Wha, Park Young Soo, Jung Hwoon-Yong, Lee Gin Hyug, Song Ho June, Kim Do Hoon, Choi Kwi-Sook, Lee Jeong Hoon, Ahn Ji Yong, Kim Mi-Young, Bae Suh Eun, Kim Jin-Ho
Hepatogastroenterology. 2015 Jan-Feb;62(137):207-13.
BACKGROUND/AIMS: Locoregional gastric carcinoids with normal serum gastrin level have been recommended radical resection regardless of tumor size or depth of invasion. However, there have been some reports which showed small sporadic gastric carcinoids could be treated with local resection. The aim of this study was to elucidate risk factors of lymph node metastasis in patients with gastric carcinoids with normal serum gastrin level and determine the indications for limited resection such as endoscopic treatment.
We performed clinicopathologic reviews of thirty gastric carcinoids with normal serum gastrin level from January 1996 to December 2010.
One case show distant metastasis and two cases showed lymph node metastasis at the time of diagnosis. For twenty seven cases which showed no regional lymph node or distant metastasis initially no additional lymph node or distant metastasis were diagnosed throughout the follow up period. Large tumor size (>10 mm), proper muscle infiltration, WHO classification grade 2 and lymphovascular invasion was noted risk factor of lymph node metastasis by univariate logistic regression analysis.
Small (≤10 mm) gastric carcinoids with normal serum gastrin level confined to submucosa can be treated with endoscopic or local resection unless lymphovascular invasion.
背景/目的：对于血清胃泌素水平正常的局部区域性胃类癌，无论肿瘤大小或浸润深度如何，均建议行根治性切除。然而，有一些报道显示，小的散发性胃类癌可行局部切除治疗。本研究的目的是阐明血清胃泌素水平正常的胃类癌患者发生淋巴结转移的危险因素，并确定有限切除（如内镜治疗）的适应证。
我们对1996年1月至2010年12月期间30例血清胃泌素水平正常的胃类癌患者进行了临床病理回顾。
1例在诊断时出现远处转移，2例出现淋巴结转移。对于最初无区域淋巴结或远处转移的27例患者，在整个随访期间未诊断出额外的淋巴结或远处转移。单因素逻辑回归分析显示，肿瘤大（>10mm）、固有肌层浸润、世界卫生组织分类2级和淋巴管侵犯是淋巴结转移的危险因素。
血清胃泌素水平正常、局限于黏膜下层的小（≤10mm）胃类癌，除非有淋巴管侵犯，可行内镜或局部切除治疗。
