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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 165 - 175 (11page)
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Purpose: 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). Materials and Methods: 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. Results: 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. Conclusions: 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.
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참고문헌 (30)
참고문헌 신청
Guideline Committee of the Korean Gastric Cancer Association / 2019 / Korean Practice Guideline for Gastric Cancer 2018; Evidence-based, Multi-disciplinary Approach / Journal of Gastric Cancer 19(1):1~48
Japanese Gastric Cancer Association / 2017 / Japanese gastric cancer treatment guidelines 2014 (ver. 4) / Gastric Cancer 20:1~19
Ono H / 2016 / Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer / Dig Endosc 28:3~15
Gotoda T / 2000 / Incidence of lymph node metastasis from early gastric cancer : estimation with a large number of cases at two large centers / Gastric Cancer 3:219~225
Chung JW / 2011 / Extended indication of endoscopic resection for mucosal early gastric cancer : analysis of a single center experience / J Gastroenterol Hepatol 26:884~887
Japanese Gastric Cancer Association / 2017 / Japanese gastric cancer treatment guidelines 2014 (ver. 4) / Gastric Cancer 20:1~19
Ono H / 2016 / Guidelines for endoscopic submucosal dissection and endoscopic mucosal resection for early gastric cancer / Dig Endosc 28:3~15
Gotoda T / 2000 / Incidence of lymph node metastasis from early gastric cancer : estimation with a large number of cases at two large centers / Gastric Cancer 3:219~225
Chung JW / 2011 / Extended indication of endoscopic resection for mucosal early gastric cancer : analysis of a single center experience / J Gastroenterol Hepatol 26:884~887
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