Japanese

Multiple Early Gastric Cancers Resected using the Endoscopic Submucosal Dissection Method Toshiyuki Mishima 1 , Hidetaka Hamamoto 1 , Naoto Miyake 1 , Toru Okuzono 1 , Hiroyuki Mizuno 1 , Yusuke Miyashita 1 , Yoshiyuki Takahashi 1 , Akira Haneda 1 , Kei Mori 1 , Shun Sato 1 , Tomoki Matsuda 1 , Junichi Ishibashi 1 , Masato Nakahori 1 , Fukuji Mochizuki 2 , Mareyuki Endo 3 , Noriyuki Iwama 3 , Akimichi Chonan 1 1Digestive Endoscopy Center, Sendai Kousei Hospital, Sendai, Japan 2Health Care Center, Sendai Kousei Hospital, Sendai, Japan 3Department of Pathology, Sendai Kousei Hospital, Sendai, Japan Keyword: 多発胃癌 , 通常内視鏡 , ESD , 同時多発 , 異時多発 pp.46-59
Published Date 2011/1/25
DOI https://doi.org/10.11477/mf.1403102105
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 We investgated seven hundreds and twenty five patients with early gastric cancer resected by ESD from 2003 to 2009. We extracted one hundred and sixty one patients(22.2%)with multiple early gastric cancers, and divided them into two groups : the patients with only synchronous lesions and the patients with metachronous lesions. The characteristics of multiple early gastric cancers are as follows :

 1)The number of the patients with only synchronous lesions were eighty eight(12.1%), and that of the patients with metachronous lesions were seventy three(10.1%).

 2)In the group of synchronous lesions, the rate of two-time lesions was 73.9%, and that of three-time or more was 26.1%. In the group of metachronous lesions, the rate of two-time lesions was 64.4%, and that of three-time or more was 35.6%.

 3)Concerning site of the lesions, multiple early gastric cancers are frequently detected in the M and L region.

 4)In the group with metachronous lesions, the mean size of the metachronous lesions(13.7mm)was significantly smaller than that of lesions at the time of first treatment(17.6mm).

 5)The rate of low grade differentiated type was 21.1% in the group with single early gastric cancers. Otherwise, the rate of low grade differentiated type was 37.5% in the group with synchronous lesions, and 35.6% in the group with metachronous lesions. There is a significant difference between single early gastric cancers and multiple early gastric cancers.

 6)In the group of metachronous lesions, the rate of the depth of invasion over SM2 was 4.1%.

 7)85.7% of the patients with metachronous lesions were detected within three years. But, there have been cases detected after three years or more.

 In conclusion, we have to understand these characteristics of multiple early gastric cancers, and carefully diagnose them.


Copyright © 2011, Igaku-Shoin Ltd. All rights reserved.

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

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