Gut and Liver  2017;11(6):807-812

doi:10.5009/gnl17033

The Characteristics and Prognosis of Diffuse-Type Early Gastric Cancer Diagnosed during Health Check-Ups.

Ji Young LEE 1 ; Eun Jeong GONG ; Eun Ju CHUNG ; Hye Won PARK ; Suh Eun BAE ; Eun Hee KIM ; Jaeil KIM ; Yoon Suh DO ; Tae Hyup KIM ; Hye Sook CHANG ; Ho June SONG ; Jaewon CHOE ; Hwoon Yong JUNG

Affiliations

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Keywords

Stomach neoplasms; Diffuse-type; Early diagnosis; Prognosis; Endoscopy

Country

Republic of Korea

Language

English

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.