Evaluation of Submucosal or Lymphovascular Invasion Detection Rates in Early Gastric Cancer Based on Pathology Section Interval.
Endoscopic submucosal dissection
Lymphovascular invasion
Stomach neoplasm
Submucosal invasion
Journal
Journal of gastric cancer
ISSN: 2093-582X
Titre abrégé: J Gastric Cancer
Pays: Korea (South)
ID NLM: 101559430
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
received:
30
12
2019
revised:
14
03
2020
accepted:
19
03
2020
entrez:
30
6
2020
pubmed:
1
7
2020
medline:
1
7
2020
Statut:
ppublish
Résumé
The guidelines for pathological evaluation of early gastric cancer (EGC) recommend wider section intervals for surgical specimens (5-7 mm) than those for endoscopically resected specimens (2-3 mm). Studies in surgically resected EGC specimens showed not negligible lymph node metastasis risks in EGCs meeting the expanded criteria for endoscopic submucosal dissection (ESD). This retrospective study included 401 EGC lesions with an endoscopic size of ≤ 30 mm detected in 386 patients. Pathological specimens obtained by ESD or surgery were cut into 2-mm section intervals for reference. Submucosal or lymphovascular invasion (LVI) was evaluated arbitrarily in 4- or 6-mm section intervals. McNemar's tests compared the differences between submucosal and LVI. Submucosal invasion was detected in 29.2% (117/401) and LVI in 9.5% (38/401) at 2-mm interval. The submucosal invasion detection rates in 4-mm intervals decreased to 88.0% or 90.6% (both P<0.001), while the LVI detection rates decreased to 86.8% or 57.9% (P=0.025 and P<0.001, respectively). In 6-mm intervals, the submucosal and LVI detection rates decreased further to 72.7-80.3% (P<0.001 for all three sets) and 55.3-63.2% (P<0.001 for all three sets), respectively. Among 150 out-of-indication cases at 2-mm interval, 4-10 (2.7%-6.7%) at 4-mm intervals, and 10-17 (6.7%-11.3%) at 6-mm intervals were misclassified as lesions meeting the curative resection criteria due to the underestimation of submucosal or LVI. After ESD, the 2-mm wide section interval was suitable for the pathological evaluation of focal submucosal or LVI. Thus, if an EGC lesion meets the expanded criteria for the ESD specimen pathological evaluation, it could be safely followed up.
Identifiants
pubmed: 32596000
doi: 10.5230/jgc.2020.20.e14
pmc: PMC7311219
doi:
Types de publication
Journal Article
Langues
eng
Pagination
165-175Informations de copyright
Copyright © 2020. Korean Gastric Cancer Association.
Déclaration de conflit d'intérêts
Conflict of Interest: No potential conflict of interest relevant to this article was reported.
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