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Related Concept Videos

Gastritis-I: Introduction and Types01:27

Gastritis-I: Introduction and Types

Gastritis, defined by the inflammation or irritation of the stomach lining or gastric mucosa, manifests in several distinct forms: acute, chronic, reactive, and a specific subtype known as autoimmune metaplastic atrophic gastritis.
Acute gastritis presents as a sudden inflammation triggered by various stressors to the stomach lining, such as exposure to corrosive agents, local irritants like aspirin and other NSAIDs, alcohol consumption, radiation therapy, physical trauma, severe burns, sepsis,...

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Endoscopic Submucosal Dissection Criteria for Differentiated-type Early Gastric Cancer Are Applicable to Mixed-type

Zhen Yang1,2, Jin Yan2, Hai-Sheng Qian2

  • 1Department of Gastroenterology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou.

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|April 23, 2024
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Mixed-type differentiated predominant early gastric cancer (MD-EGC) shows higher invasion rates but favorable long-term prognosis after endoscopic submucosal dissection (ESD) if curative resection is achieved. Further research is needed for MD-EGC treatment guidelines.

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Area of Science:

  • Gastroenterology
  • Oncology
  • Surgical Endoscopy

Background:

  • Mixed-type differentiated predominant early gastric cancer (MD-EGC) lacks sufficient evidence for endoscopic treatment guidelines based on differentiated-type early gastric cancer (EGC) criteria.
  • Endoscopic submucosal dissection (ESD) is a key treatment for EGC, but its efficacy in MD-EGC requires evaluation.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of endoscopic submucosal dissection (ESD) for mixed-type differentiated predominant early gastric cancer (MD-EGC).
  • To compare the clinicopathological characteristics, resection outcomes, and recurrence/survival rates of MD-EGC with pure differentiated-type EGC (PD-EGC) treated with ESD.

Main Methods:

  • Retrospective review of patients with EGC treated with ESD between January 2015 and June 2021.
  • Comparison of clinical and pathological data, including invasion rates, resection success, and patient survival, between MD-EGC and PD-EGC groups.

Main Results:

  • MD-EGC demonstrated significantly higher rates of submucosal invasion (37.5% vs. 13.7%) and lymphatic invasion (10.4% vs. 0.4%) compared to PD-EGC.
  • Complete resection (70.8% vs. 92.5%) and curative resection (54.2% vs. 87.4%) rates were lower for MD-EGC.
  • MD-EGC was an independent risk factor for noncurative resection (OR 4.26), but no significant differences in recurrence or survival rates were observed when curative resection was achieved.

Conclusions:

  • MD-EGC exhibits greater malignancy and a lower endoscopic curative resection rate compared to PD-EGC.
  • Despite challenges, patients with MD-EGC achieving curative resection through ESD have a favorable long-term prognosis.
  • These findings suggest ESD can be effective for MD-EGC when curative resection is successful, though careful patient selection is crucial.