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Clinicopathological Characteristics of Intramucosal Gastric Carcinoma with Lymph Node Metastasis Hiroshi Tanabe 1,2 , Akinori Iwashita 1 , Seiji Haraoka 1 , Keisuke Ikeda 1,2 , Kaname Ohshige 1,2 , Astuko Ota 1,3 , Nobuaki Nishimata 1,2 , Kitaro Futami 3 , Toshiyuki Matsui 2 1Department of Pathology, Chikushi Hospital, Fukuoka University, Chikushino, Japan 2Department of Gastroenterology, Chikushi Hospital, Fukuoka University, Chikushino, Japan 3Department of Surgery, Chikushi Hospital, Fukuoka University, Chikushino, Japan Keyword: 胃粘膜内癌 , リンパ節転移 , 胃型粘液形質 , EMR適応条件 pp.1119-1129
Published Date 2006/7/25
DOI https://doi.org/10.11477/mf.1403100622
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 We investigated 669 cases of intramucosal gastric carcinomas treated with surgical resection and evaluated the characteristics of lesions with lymph node metastasis, clinicopathologically.

 The incidence of lymph node metastasis was 2.1% (14 cases) among 669 cases of intramucosal gastric carcinomas, and mucosal carcinomas with lymph node metastasis were characterized by : women, younger than 60 years old (p<0.05), large size (31mm≦) (p<0.01), undifferentiated-type (p<0.05), mixed-type in differentiated-type (p<0.05), depressed-type, and the presence of ulceration in the lesion (p<0.01). In addition, the mucin phenotypes of all lesions with lymph node metastasis are, immunohistochemically, gastric mucin phenotypes (12 lesions) or gastric predominant gastric and intestinal mucin phenotypes (2 lesions), and all undifferentiated-type gastric carcinomas with lymph node metastasis (9 lesions) show no double layer of MUC5AC/MUC6 and no Ki-67 localization in the carcinoma cells.

 We examined the relationships between clinicopathological features of intramucosal gastric carcinomas, especially their macroscopic type, histological type, presence of ulceration in the lesion, and size. Intramucosal gastric carcinomas without lymph node metastasis were as follows : ( 1 ) Any size of protruded, elevated and flat type carcinomas without ulceration, ( 2 ) All macroscopic and histological types with or without ulceration less than 10mm in diameter, ( 3 ) Lesions indicated by guidelines for EMR, such as differentiated-type carcinomas less than 20mm in diameter, and depressed type lesions without ulceration.


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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