Evaluation of Submucosal or Lymphovascular Invasion Detection Rates in Early Gastric Cancer Based on Pathology Section Interval
Copyright © 2020. Korean Gastric Cancer Association..
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.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2020 |
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Erschienen: |
2020 |
Enthalten in: |
Zur Gesamtaufnahme - volume:20 |
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Enthalten in: |
Journal of gastric cancer - 20(2020), 2 vom: 25. Juni, Seite 165-175 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Kim, Young-Il [VerfasserIn] |
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Links: |
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Themen: |
Endoscopic submucosal dissection |
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Anmerkungen: |
Date Revised 29.03.2024 published: Print-Electronic Citation Status PubMed-not-MEDLINE |
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doi: |
10.5230/jgc.2020.20.e14 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM311741274 |
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520 | |a Copyright © 2020. Korean Gastric Cancer Association. | ||
520 | |a 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) | ||
520 | |a 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 | ||
520 | |a 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 | ||
520 | |a 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 | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a Endoscopic submucosal dissection | |
650 | 4 | |a Lymphovascular invasion | |
650 | 4 | |a Stomach neoplasm | |
650 | 4 | |a Submucosal invasion | |
700 | 1 | |a Kook, Myeong-Cherl |e verfasserin |4 aut | |
700 | 1 | |a Choi, Jee Eun |e verfasserin |4 aut | |
700 | 1 | |a Lee, Jong Yeul |e verfasserin |4 aut | |
700 | 1 | |a Kim, Chan Gyoo |e verfasserin |4 aut | |
700 | 1 | |a Eom, Bang Wool |e verfasserin |4 aut | |
700 | 1 | |a Yoon, Hong Man |e verfasserin |4 aut | |
700 | 1 | |a Ryu, Keun Won |e verfasserin |4 aut | |
700 | 1 | |a Kim, Young-Woo |e verfasserin |4 aut | |
700 | 1 | |a Choi, Il Ju |e verfasserin |4 aut | |
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