Health Screening and Promotion Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Gut Liver. 2017 Nov 15;11(6):807-812. doi: 10.5009/gnl17033.
BACKGROUND/AIMS: Because of the poor prognosis of diffuse-type gastric cancer, early detection is important. We investigated the clinical characteristics and prognosis of diffuse-type early gastric cancer (EGC) diagnosed in subjects during health check-ups.
Among 121,111 subjects who underwent gastroscopy during a routine health check-up, we identified 282 patients with 286 EGC lesions and reviewed their clinical and tumor-specific parameters.
Patients with diffuse-type EGC were younger, and 48.1% of them were female. Serum anti- IgG (Hp-IgG) was positive in 90.7% of diffuse-type EGC patients (vs 75.9% of intestinal-type EGC, p=0.002), and the proportion of diffuse-type EGC cases increased significantly with increasing Hp-IgG serum titers (p<0.001). Diffuse-type EGC had pale discolorations on the tumor surface (26.4% vs 4.0% in intestinal-type EGC, p<0.001) and were often located in the middle third of the stomach. Submucosal invasion or regional nodal metastasis was observed more commonly in patients with diffuse-type EGC. However, during the median follow-up period of 50 months, 5-year disease-free survival rates did not differ between the groups.
Diffuse-type EGC shows different clinical and endoscopic characteristics. Diffuse-type EGC is more closely associated with Hp-IgG seropositivity and a higher serum titer. Early detection results in excellent prognosis.
背景/目的：由于弥漫型胃癌预后较差，早期发现非常重要。我们研究了在健康体检中诊断出的弥漫型早期胃癌（EGC）患者的临床特征和预后。
在 121111 名接受胃镜检查的体检者中，我们确定了 282 例 286 处 EGC 病变患者，并回顾了他们的临床和肿瘤特异性参数。
弥漫型 EGC 患者较年轻，其中 48.1%为女性。血清抗 IgG（Hp-IgG）在弥漫型 EGC 患者中阳性率为 90.7%（肠型 EGC 为 75.9%，p=0.002），弥漫型 EGC 病例的比例随着 Hp-IgG 血清滴度的增加而显著增加（p<0.001）。弥漫型 EGC 肿瘤表面呈苍白变色（26.4%比肠型 EGC 的 4.0%，p<0.001），且常位于胃的中三分之一。黏膜下浸润或区域淋巴结转移在弥漫型 EGC 患者中更为常见。然而，在中位随访 50 个月期间，两组 5 年无病生存率无差异。
弥漫型 EGC 表现出不同的临床和内镜特征。弥漫型 EGC 与 Hp-IgG 血清阳性和更高的血清滴度更密切相关。早期发现可获得良好的预后。
