Gut Liver.
2017 Nov;11(6):807-812. 10.5009/gnl17033.
The Characteristics and Prognosis of Diffuse-Type Early Gastric Cancer Diagnosed during Health Check-Ups
- Affiliations
-
- 1Health Screening and Promotion Center, University of Ulsan College of Medicine, Seoul, Korea. drchoe@hotmail.com
- 2Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. hjsong@amc.seoul.kr
- KMID: 2395385
- DOI: http://doi.org/10.5009/gnl17033
Abstract
- BACKGROUND/AIMS
Because of the poor prognosis of diffuse-type gastric cancer, early detection is important. We investigated the clinical characteristics and prognosis of diffuse-type early gastric cancer (EGC) diagnosed in subjects during health check-ups.
METHODS
Among 121,111 subjects who underwent gastroscopy during a routine health check-up, we identified 282 patients with 286 EGC lesions and reviewed their clinical and tumor-specific parameters.
RESULTS
Patients with diffuse-type EGC were younger, and 48.1% of them were female. Serum anti-Helicobacter pylori IgG (Hp-IgG) was positive in 90.7% of diffuse-type EGC patients (vs 75.9% of intestinal-type EGC, p=0.002), and the proportion of diffuse-type EGC cases increased significantly with increasing Hp-IgG serum titers (p < 0.001). Diffuse-type EGC had pale discolorations on the tumor surface (26.4% vs 4.0% in intestinal-type EGC, p < 0.001) and were often located in the middle third of the stomach. Submucosal invasion or regional nodal metastasis was observed more commonly in patients with diffuse-type EGC. However, during the median follow-up period of 50 months, 5-year disease-free survival rates did not differ between the groups.
CONCLUSIONS
Diffuse-type EGC shows different clinical and endoscopic characteristics. Diffuse-type EGC is more closely associated with Hp-IgG seropositivity and a higher serum titer. Early detection results in excellent prognosis.
