Clinical study of multifocal phenomenon for gastric cancer and gastric high-grade intraepithelial neoplasia / 中国肿瘤临床

ABSTRACT

Objective: To investigate the clinicopathological characteristics and relevance of main and minor lesions of synchronous multiple gastric cancer and gastric high-grade intraepithelial neoplasia. Methods: We retrospectively reviewed 56 patients with synchronous multiple gastric cancer and gastric high-grade intraepithelial neoplasia who had been treated with operation and endoscopic submucosal dissection. Their clinicopathologic characteristics were summarized, and the correlation between main and minor lesions were analyzed. Results: Among the 56 patients, with a mean age of (63.82±11.88) years, 75% were men whereas 25% were women. Twenty-five (44.64%) patients had mucosal atrophy. The depth of tumor invasion in main and minor lesions was mainly stage T1. The size of main and minor lesions showed a positive correlation (r=0.797, P<0.001). The pathologic type of main and minor lesions demonstrated a moderately significant positive correlation (P=0.007). The endoscopic classification between major and minor lesions had a statistically significant consistency (P<0.001). The comparison of location between main and minor lesions showed a correlation the correlation coefficient of the vertical position was 0.484 (P=0.002) and that of the horizontal position was 0.535 (P=0.007). Main lesions in multifocal gastric cancer or high-grade gastric intraepithelial neoplasia differed from single-focal gastric cancer or high-grade gastric intraepithelial neoplasia in terms of lymphatic metastasis, the TNM stage, and mucosal atrophy. Conclusions: Old men who had lesions combined with mucosal atrophy were considered as the high-risk group among patients with synchronous multiple gastric cancer and gastric high-grade intraepithelial neoplasia. Therefore, clinicians must keep a high grade of suspicion and make careful observations during the endoscopic examination, considering the correlation between main and minor lesions, in order to avoid any misdiagnosis.