Distinct clinicopathological differences between early gastric cardiac and non-cardiac carcinomas: a single-center retro
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RESEARCH ARTICLE
Distinct clinicopathological differences between early gastric cardiac and non‑cardiac carcinomas: a single‑center retrospective study of 329 radical resection cases Yaohui Wang1, Xiuqing Li1, Lili Gao1, Chenxi Wang1, Yifen Zhang1* and Qin Huang2,3*
Abstract Background: Early gastric carcinoma is heterogeneous and can be divided into early gastric cardiac carcinoma (EGCC) and early gastric non-cardiac carcinoma (EGNCC) groups. At present, differences in clinicopathology remains obscure between EGCC and EGNCC fundus–corpus and antrum–angularis–pylorus subgroups, especially between EGCC with and without oesophageal invasion. Methods: In this study, we studied 329 consecutive early gastric carcinoma radical gastrectomies with 70 EGCCs and 259 EGNCCs. Results: Compared to the EGNCC antrum–angularis–pylorus (n = 181), but not fundus–corpus (n = 78), sub-group, EGCC showed significantly older age, lower prevalence of the grossly depressed pattern, better tumor differentiation, higher percentage of tubular/papillary adenocarcinoma, but lower frequency of mixed poorly cohesive carcinoma with tubular/papillary adenocarcinoma, and absence of lymph node metastasis (LNM) in tumors with invasion up to superficial submucosa (SM1). In contrast, pure poorly cohesive carcinoma was less frequently seen in EGCCs than in EGNCCs, but mixed poorly cohesive carcinoma with tubular/papillary adenocarcinomas was significantly more common in the EGNCC antrum–angularis–pylorus sub-group than in any other group. No significant differences were found between EGCC and EGNCC sub-groups in gender, tumor size, H. pylori infection rate, and lymphovascular/perineural invasion. EGCC with oesophageal invasion (n = 22), compared to EGCC without (n = 48), showed no significant differences in the H. pylori infection rate and oesophageal columnar, intestinal, or pancreatic metaplasia, except for a higher percentage of the former in size > 2 cm and tubular differentiation. Conclusions: There exist distinct clinicopathologic differences between EGCC and EGNCC sub-groups; EGCC was indeed of gastric origin. Further investigations with larger samples are needed to validate these findings. Keywords: Early gastric carcinoma, Early gastric cardiac carcinoma, Clinicopathologic features, Oesophageal invasion
*Correspondence: [email protected]; [email protected] 1 Department of Pathology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China 2 Department of Pathology, Nanjing Drum Tower Hospital, Nanjing, China Full list of author information is available at the end of the article
Background Gastric cancer is heterogeneous in epidemiology, pathology, and pathogenesis mechanisms, and may be divided into cardiac and non-cardiac categories [1, 2], both of which show dismal prognosis. At present, the best strategy to improve gastric cancer patient outcomes is early detection with prompt resection of early gastric
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