Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Sep 16, 2021; 13(9): 426-436
Published online Sep 16, 2021. doi: 10.4253/wjge.v13.i9.426
Enlarged folds on endoscopic gastritis as a predictor for submucosal invasion of gastric cancers
Osamu Toyoshima, Shuntaro Yoshida, Toshihiro Nishizawa, Akira Toyoshima, Kosuke Sakitani, Tatsuya Matsuno, Tomoharu Yamada, Takashi Matsuo, Hayato Nakagawa, Kazuhiko Koike
Osamu Toyoshima, Shuntaro Yoshida, Toshihiro Nishizawa, Kosuke Sakitani, Tatsuya Matsuno, Tomoharu Yamada, Department of Gastroenterology, Toyoshima Endoscopy Clinic, Setagaya-ku 157-0066, Tokyo, Japan
Toshihiro Nishizawa, Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita 286-8520, Chiba, Japan
Akira Toyoshima, Department of Colorectal Surgery, Japanese Red Cross Medical Center, Shibuya-ku 150-8935, Tokyo, Japan
Kosuke Sakitani, Department of Gastroenterology, Sakitani Endoscopy Clinic, Narashino 275-0026, Chiba, Japan
Tatsuya Matsuno, Tomoharu Yamada, Hayato Nakagawa, Kazuhiko Koike, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku 113-8655, Tokyo, Japan
Takashi Matsuo, Department of Internal Medicine, Sakura Internal Medicine Clinic, Setagaya-ku 157-0071, Tokyo, Japan
Author contributions: Toyoshima O designed the study, recruited patients, analyzed the data, and wrote the manuscript; Nishizawa T designed the study, recruited patients, edited, and revised the manuscript; Yoshida S recruited patients and revised the manuscript; Toyoshima A, Matsuno T, Yamada T, Matsuo T, Nakagawa H, and Koike K revised the manuscript; Sakitani K reviewed endoscopic images and revised the manuscript.
Institutional review board statement: This retrospective study was approved by Certificated Review Board, Hattori Clinic on September 4, 2020 (approval No. S2009-U04).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Toshihiro Nishizawa, MD, PhD, Professor, Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, 852 Hatakeda, Narita 286-8520, Chiba, Japan. nisizawa@kf7.so-net.ne.jp
Received: May 29, 2021
Peer-review started: May 29, 2021
First decision: June 11, 2021
Revised: June 12, 2021
Accepted: July 6, 2021
Article in press: July 6, 2021
Published online: September 16, 2021
Core Tip

Core Tip: We investigated predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis. We analyzed the effects of patient and tumor characteristics, including the Kyoto classification, on submucosal tumor invasion. Two hundred sixty-six gastric cancer patients were enrolled. Multivariate analysis revealed that low body mass index, no surveillance esophagogastroduodenoscopy within 2 years, endoscopic enlarged folds of gastritis, and Lauren’s diffuse-type were independently associated with submucosal invasion. Among cancer patients with enlarged folds, severely enlarged folds (width ≥ 10 mm) were more related to submucosal invasion than mildly enlarged folds (width 5-9 mm). Enlarged folds of gastritis were associated with submucosal invasion.