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Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers
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Jaesin Lee, Byung-Wook Kim, Cheal Wung Huh, Joon Sung Kim, Lee-So Maeng
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Clin Endosc 2020;53(3):328-333. Published online January 7, 2020
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DOI: https://doi.org/10.5946/ce.2019.133
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 Abstract
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- Background
/Aims: Predicting histological ulceration in early gastric cancer (EGC) during endoscopic examination is crucial for endoscopists deciding on the treatment modality. The aim of this study was to investigate the endoscopic factors that can predict histological ulcerations in EGCs.
Methods
We retrospectively analyzed patients who underwent endoscopic submucosal dissection (ESD) for EGC. Clinical features and endoscopic characteristics of EGC such as location, histological differentiation, longest diameter, tumor morphology, mucosal break, converging fold, color change, and surface irregularity were reviewed. Histological ulceration was defined based on ESD specimens.
Results
A total of 633 EGC lesions from 613 patients were included and histological ulcerations were found in 90 lesions (14.2%). Presence of converging folds, tumor morphology, and color changes on endoscopic examination were related to histological ulceration in the univariate analysis and converging folds along with color changes were statistically significant factors in the multivariate analysis. Kaplan–Meier analysis showed that patients with histological ulcerations in EGCs tended to have higher marginal recurrence rates.
Conclusions
Mucosal breaks are not equivalent to histological ulcerations. Rather, the existence of converging folds and color changes during endoscopic examination suggest histological ulcerations. Endoscopists should consider these factors when they decide the treatment modality for EGCs.
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Citations
Citations to this article as recorded by  - Clinical Impact of Proton Pump Inhibitor and Potassium-Competitive Acid Blocker for Predicting the Curability of Endoscopic Resection in Ulcerative Early Gastric Cancer
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Journal of the Korean Medical Association.2022; 65(5): 267. CrossRef - Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
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Journal of the Korean Medical Association.2022; 65(5): 284. CrossRef - Construction and analysis of an ulcer risk prediction model after endoscopic submucosal dissection for early gastric cancer
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Oncology Letters.2022;[Epub] CrossRef - Discrepancy between endoscopic and pathological ulcerative findings in clinical intramucosal early gastric cancer
Yohei Yabuuchi, Kohei Takizawa, Naomi Kakushima, Noboru Kawata, Masao Yoshida, Yoichi Yamamoto, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Hirotoshi Ishiwatari, Kinichi Hotta, Hiroyuki Matsubayashi, Etsuro Bando, Masanori Terashima, Takashi Sugino, Hiro
Gastric Cancer.2021; 24(3): 691. CrossRef - What is the Most Precise Endoscopic Finding for Predicting the Clinicopathological Behaviors in Ulcerative Early Gastric Cancer?
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