OBJECTIVETo explore the factors associated with early diagnosis of gastric cancer.

METHODSClinical data were retrospectively analyzed for 250 patients with early-stage gastric cancer (EGC) from 2005 to 2008, during which the concept of intra-epithelial neoplasia (IN) was adopted in our department.

RESULTSOn preoperative endoscopic biopsy with pathological exam, there were 15 cases suspicious for cancer, 90 with high-grade IN (HGIN), and 15 gastric cancer. Postoperative pathological exam of the surgical specimen showed infiltrating early-stage cancer in 224 patients, of which 5 (2.2%) were type I (all were Tsm), 190 (84.8%) were type II including Tm in 82 and Tsm in 108 patients, 29 were type III (5 Tm and 24 Tsm). Twenty-six patients had non-infiltrating lesions (Tis). There were 184 (73.6%) well-differentiated tumors, including 26 Tis, 58 Tm, and 100 Tsm. Lymphatic metastasis was identified in 21 patients, of which 2 (2.3%) were Tm (all were poorly-differentiated) and 19 (13.9%) were Tsm. Lymphadenopathy was present in 15 (7.9%) cases in type II, and in 6 (20.7%) in type III. Of the 90 cases with a preoperative diagnosis of HGIN, 24 were found to be Tis, 29 were Tm, and 37 were Tsm on postoperative pathological assessment.

CONCLUSIONSWell-differentiation is the main histological type in EGC. The adoption of the concept of IN is associated with improved detection of EGC, which warrants further investigation.