Correspondence of Endoscopic Findings with Histologic Differentiation in Early Gastric Cancer

Jeong, Hyun Yong; Lee, Seung Min; Lee, Kyung Tae; Kim, Seok Hyun; Lee, Byoung Seok; Kim, Jin Hee; Kim, Nam Jae; Rho, Seung Moo; Song, Kyu Sang

Abstract

BACKGROUND/AIMS: The aim of this study was to investigate the endoscopic findings of early gastric cancer according to histological differentiation.
METHODS
One hundred eight cases of early gastric cancer (EGC) which had been confirmed surgically over a 1 year and 7 month period, were studied to assess the relationship between histological differentiation and endoscopic findings.
RESULTS
All elevated types of EGC (41 cases) were found to be differentiated carcinoma. 48.2% (30/67 cases) of the depressed type EGC was determined to be differentiated carcinoma, while the others (51.8%) were undifferentiated carcinoma. Twenty-four of thirty cases with differentiated depressed type EGC showed a reddish discolored surface (80%), and the others manifested a whitish or mixed colored surface of red and white. In the undifferentiated depressed type EGC, 73% (27/37 cases) revealed a whitish or mixed colored surface, while the others (27%) showed a reddish discoloration. In the differentiated depressed type EGC, the character of the depressed surface was mainly regular and soft or fine granular (77%), while that of the undifferentiated cases appeared as uneven large granules (43.2%) or fine granules (43.2%), sclerotic (2.8%) and/or elevated (10.8%). The margin of the depressed type EGC with differentiated carcinoma was mainly of a shoaling beach type (83.3%), and that of the undifferentiated carcinoma was not uniform and existed as a cliff type (60%), Riasis coast type (11.4%) and shoaling beach type (28.6%).
CONCLUSIONS
All elevated types of EGC showed differentiated types, and histological differentiation of depressed type EGC was macroscopically determined by the size of lesions, color, and character of the depressed surface and margin of the depression.