Published online Aug 15, 2017. doi: 10.4251/wjgo.v9.i8.319
Peer-review started: March 29, 2017
First decision: May 5, 2017
Revised: May 9, 2017
Accepted: June 6, 2017
Article in press: June 7, 2017
Published online: August 15, 2017
To investigate the clinicopathological variables in early gastric cancer (EGC) patients in relation to differentiation discrepancy.
The data of 265 specimens from 240 patients with EGC, who had undergone radical operation at Hallym University Sacred Heart Hospital from 2010 to 2015, were retrospectively analyzed. We evaluated clinical, endoscopic, and histopathological data according to histological discrepancy.
Clinically significant discrepancy rate showed the difference in differentiated type (well and moderately differentiated) and undifferentiated type (poorly differentiated and signet ring cell) between endoscopic biopsies and postoperative specimens was 9.4% (25/265). There were no differences in tumor location, size, gross pattern, and number of biopsies. Specimens having histological discrepancy showed more submucosal invasion (72.0% vs 49.6%, P = 0.033) and lymph node involvement (24.0% vs 7.9%, P = 0.009) than specimens having non-discrepancy. The rate of a positive epidermal growth factor receptor status was higher in specimens having discrepancy than in specimens having non-discrepancy (81.0% vs 55.4%, P = 0.035).
The discordance of histologic differentiation is associated with higher submucosal invasion and lymph node metastases in EGC. Patients have histological discrepancy may require additional surgical treatments.
Core tip: The discordance of differentiation between forceps biopsies and endoscopically resected specimens may necessitate a radical gastrectomy and predict poor outcomes. We analyzed clinicopathological variables of early gastric cancer patients in relation to differentiation discrepancy. Clinically significant discrepancy rate between endoscopic biopsies and postoperative specimens was 9.4%. Specimens having histological discrepancy showed more submucosal invasion and lymph node metastases than specimens having non-discrepancy. Patients who have histological discrepancy detected in endoscopically resected specimens may require additional surgical treatments.