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Published on: February 16, 2024
Time-dependent morphologic change in depressed-type early gastric cancer
Jong Pil Im1, Sang Gyun Kim, Joo Sung Kim
1Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-799, Korea.
Surgical Endoscopy
|March 20, 2009
Summary
The malignant cycle of depressed-type early gastric cancer (EGC) was frequently observed. Improvement in EGC ulceration is time-dependent, influenced by antisecretory medication and invasion depth.
Area of Science:
- Gastroenterology
- Oncology
Background:
- Depressed-type early gastric cancer (EGC) exhibits a
- malignant cycle
- characterized by recurrent ulceration improvement and exacerbation.
- Clinicopathologic factors influencing this cycle remain poorly understood.
Purpose of the Study:
- To evaluate the occurrence of the malignant cycle in depressed-type EGC.
- To identify clinicopathologic factors associated with time-dependent morphologic changes in EGC ulceration.
Main Methods:
- Retrospective review of medical records and endoscopic images from 231 EGC patients (1999-2005).
- Classification of ulcer stages using the gastric ulcer stage system.
- Evaluation of time-dependent morphologic changes based on relevant factors.
Main Results:
- A change in ulcer stage was observed in 29% of patients at follow-up endoscopy (median 23 days).
- Improvement occurred in 20% and exacerbation in 9% of EGC cases.
- Multivariate analysis identified antisecretory medication use, mucosal cancer, and longer endoscopic intervals as factors significantly associated with ulcer stage improvement.
Conclusions:
- The malignant cycle is a frequent phenomenon in depressed-type EGC.
- Ulceration improvement in EGC is time-dependent.
- Key factors influencing improvement include antisecretory medication and depth of invasion.
