Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jun 10, 2015; 7(6): 659-664
Published online Jun 10, 2015. doi: 10.4253/wjge.v7.i6.659
Evaluation of the margins of differentiated early gastric cancer by using conventional endoscopy
Shigetaka Yoshinaga, Ichiro Oda, Seiichiro Abe, Satoru Nonaka, Haruhisa Suzuki, Hajime Takisawa, Hirokazu Taniguchi, Yutaka Saito
Shigetaka Yoshinaga, Ichiro Oda, Seiichiro Abe, Satoru Nonaka, Haruhisa Suzuki, Hajime Takisawa, Yutaka Saito, Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Hirokazu Taniguchi, Pathology Division, National Cancer Center Hospital, Tokyo 104-0045, Japan
Author contributions: Yoshinaga S performed endoscopic examinations and therapies, and also wrote this manuscript mainly; Oda I, Abe S, Nonaka S, Suzuki H, Takisawa H and Saito Y performed endoscopic examinations and therapies; Taniguchi H evaluated resected specimens pathologically and took pictures of resected specimens.
Ethics approval: We explain all patients about comprehensive prior consent arrangements that we use every data and figures except genetic materials for studies. Therefore, Institutional Review Board of our hospital did not review this study.
Informed consent: All study participants, or their legal guardian agreed to this aforementioned comprehensive prior consent.
Conflict-of-interest: The authors have no conflict of interest directly relevant to the contents of this study.
Data sharing: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Shigetaka Yoshinaga, MD, PhD, Endoscopy Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan. shiyoshi@ncc.go.jp
Telephone: +81-3-35422511 Fax: +81-3-35423815
Received: August 19, 2014
Peer-review started: August 21, 2014
First decision: September 28, 2014
Revised: February 6, 2015
Accepted: March 5, 2015
Article in press: March 9, 2015
Published online: June 10, 2015
Abstract

AIM: To evaluate the determination of the margin of differentiated-type early gastric cancers by using conventional endoscopy.

METHODS: We retrospectively evaluated 364 differentiated early gastric cancers that were endoscopically resected as en-bloc specimens and diagnosed pathologically in detail between November 2007 and October 2008. All procedures were done with conventional endoscopes and all endoscopic samples, before and after indigo carmine dye, were re-evaluated using a digital filing system by one endoscopist. We analyzed the incidence of lesions with unclear margins and the relationship between unclear margins and relevant clinicopathological findings.

RESULTS: The rate of lesions with unclear margins was 20.6% (75/364). Multivariate regression analysis suggested that the factors that make the determination of the margin difficult were normal color, presence of components of flat area (0-IIb), a diameter ≥ 21 mm, ulceration, and components of poorly differentiated adenocarcinoma in the mucosal surface.

CONCLUSION: As many as 20% of differentiated early gastric cancers show unclear margins. Consideration of the factors associated with unclear margins may help endoscopists to accurately determine the margins of the lesion.

Keywords: Early gastric cancer, Conventional endoscopy, Determination of the margin

Core tip: As many as 20% of differentiated early gastric cancers show unclear margins by using conventional endoscopy. Consideration of the factors associated with unclear margins, such as normal color, presence of components of flat area (0-IIb), a diameter ≥ 21 mm, ulceration, and components of poorly differentiated adenocarcinoma in the mucosal surface, may help endoscopists to accurately determine the margins of the lesion.