Clinicopathologic Findings of Early Gastic Cancer

Ko, Young Bae; Kim, Won Gon; Kim, Joon Mee

Abstract

PURPOSE: The prognosis forearly gastric cancer (EGC) is generally excellent after curative gastrectomy alone. However, the EGC of young patients was generally more invasive and metastasizing, and the prognosis of them was poorer than those of the elderly. We performed a retrospective study to evaluate clinica1 and pathological factors influencing the prognosis of EGC.
MATERIALS AND METHODS
The authors investigated 66 cases of EGC resected at Inha Hospital in Song-Nam, from January 1987 to December 1996. We analyzed 9 clinicopathologic factors: age, sex, macroscopic type, tumor size, depth of invasion, location, lymph node metastasis, Williss classification and Laurens classification.
RESULTS
Out of 66 cases (42 males, 24 females) of EGC, the sex ratio (M: F) was 1.75: 1, and the mean age was 55.5 years in male and 54.3 in female. The age incidence revealed a greater prevalence on 6th decade (33.3%). The most common macroscopic type of EGC was IIb and its combined type (43 cases, 65.2%). In tumor size, 16 cases (24.2%) were between 2.0 and 2.9 cm, and 13 cases (19.6%) between 1.0 and 1.9 cm, 10 cases (15%) between 3.0 and 3.9 cm. The tumors smaller than 2.0 cm were 33.2% but greater than 5.0 cm were 18.8%. In male, mucosal lesions were more common (66.6%) than submucosal lesions (33.4%); but in female, the incidence of both types of lesions were the same. The submucosal lesion in female was the most frequent at 4th decade. The major location of EGC was antrum (51.5%). Lymph node metastases were found in 3 females and 1 male. By Williss classification, poorly differentiated adenocarcinoma and signet ring cell carcinoma were more common in female (29.2%, 25%) than in male (11.9%, 14.3%). By Laurens classification, the diffuse type was more common in female (50%) than in male (33.3%). This type was the most frequent in 4th decade female patients. However, none of the above data reached statistical significance.
CONCLUSION
We found the generalized tendency, though not statistically confinned, that the young female patients of EGC frequently had larger and poorly differentiated, diffuse adenocarcinomas with more frequent lymph node metastasis than male. The authors emphasizes that a further study would be needed in young female patients of EGC on hormonal factors influencing its clinicopathologic findings.