Kim Jung Ho, Jeong Seok Hoo, Yeo Jina, Lee Woon Kee, Chung Dong Hae, Kim Kyoung Oh, Chung Jun-Won, Kim Yoon Jae, Kwon Kwang An, Park Dong Kyun
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.; Depatment of Internal Medicine, School of Medicine, Gachon University, Incheon, Korea.; Gachon Medical Research Institute, Gachon University Gil Medical Center, Incheon, Korea.
Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea .
J Korean Med Sci. 2016 Jun;31(6):873-8. doi: 10.3346/jkms.2016.31.6.873. Epub 2016 Apr 15.
The detection rate of early gastric cancer (EGC) is increasing due to improvements in diagnostic methods, but synchronous multiple EGC (SMEGC) remains a major problem. Therefore, we investigated the characteristics of and the correlation between the main and minor lesions of SMEGC. We retrospectively reviewed the medical records of patients with EGC between April 2008 and May 2013. The main lesion was defined as the one with the greatest invasion depth. If lesions had the same invasion depth, the tumor diameter was used to define the main lesion. Of 963 patients who had treatment for EGC, 37 patients with SMEGC were analyzed. The main and minor lesions showed a significant positive correlation of size (r = 0.533, P = 0.001). The main and minor lesions of SMEGC showed the same vertical and horizontal locations at 70.3% and 64.9%, respectively (P = 0.002 and P = 0.002). Macroscopic types were identical in 67.6% (P < 0.001), and 32.4% had identical macroscopic type and location. The main and minor lesions had identical characteristics of invasion depth, presence of lymphovascular invasion (LVI), and differentiation in 78.4%, 83.8%, and 83.8%, respectively. Differentiation, LVI, and invasion depth (microscopic characteristics) were simultaneously the same in 62.2%. The location, macroscopic type, and 3 microscopic characteristics were matched in 27%. The main and minor lesions of SMEGC have similar clinicopathologic characteristics. Therefore, the possibility of SMEGC should not be neglected in cases of EGC, considering an understanding of the characteristics and association of lesions.
由于诊断方法的改进，早期胃癌（EGC）的检出率正在上升，但同时性多原发性早期胃癌（SMEGC）仍然是一个主要问题。因此，我们研究了SMEGC主要病变和次要病变的特征及其相关性。我们回顾性分析了2008年4月至2013年5月期间EGC患者的病历。主要病变定义为浸润深度最深的病变。如果病变的浸润深度相同，则用肿瘤直径来定义主要病变。在963例接受EGC治疗的患者中，分析了37例SMEGC患者。主要病变和次要病变的大小呈显著正相关（r = 0.533，P = 0.001）。SMEGC的主要病变和次要病变在垂直和水平位置上分别有70.3%和64.9%相同（P = 0.002和P = 0.002）。大体类型在67.6%的病例中相同（P < 0.001），32.4%的病例大体类型和位置相同。主要病变和次要病变在浸润深度、存在脉管侵犯（LVI）和分化方面分别有78.4%、83.8%和83.8%相同。分化、LVI和浸润深度（微观特征）同时相同的病例占62.2%。位置、大体类型和3项微观特征匹配的病例占27%。SMEGC的主要病变和次要病变具有相似的临床病理特征。因此，在EGC病例中，考虑到对病变特征和关联的了解，不应忽视SMEGC的可能性。
