Enlarged folds on endoscopic gastritis as a predictor for submucosal invasion of gastric cancers  

作　　者：Osamu Toyoshima Shuntaro Yoshida Toshihiro Nishizawa Akira Toyoshima Kosuke Sakitani Tatsuya Matsuno Tomoharu Yamada Takashi Matsuo Hayato Nakagawa Kazuhiko Koike 

机构地区：[1]Department of Gastroenterology,Toyoshima Endoscopy Clinic,Setagayaku 157-0066,Tokyo,Japan [2]Department of Gastroenterology and Hepatology,International University of Health and Welfare,Narita Hospital,Narita 286-8520,Chiba,Japan [3]Department of Colorectal Surgery,Japanese Red Cross Medical Center,Shibuya-ku 150-8935,Tokyo,Japan [4]Department of Gastroenterology,Sakitani Endoscopy Clinic,Narashino 275-0026,Chiba,Japan [5]Department of Gastroenterology,Graduate School of Medicine,The University of Tokyo,Bunkyo-ku 113-8655,Tokyo,Japan [6]Department of Internal Medicine,Sakura Internal Medicine Clinic,Setagayaku 157-0071,Tokyo,Japan

出　　处：《World Journal of Gastrointestinal Endoscopy》2021年第9期426-436,共11页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;however,evaluating invasion depth based on endoscopic background gastritis remains unclear.AIM To investigate predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis.METHODS Patients with gastric cancer detected on esophagogastroduodenoscopy at Toyoshima Endoscopy Clinic were enrolled.We analyzed the effects of patient and tumor characteristics,including age,sex,body mass index,surveillance endoscopy within 2 years,current Helicobacter pylori infection,the Kyoto classification,and Lauren’s tumor type,on submucosal tumor invasion and curative endoscopic resection.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Atrophy was characterized by non-reddish and low mucosa.Intestinal metaplasia was detected as patchy whitish or grayish-white flat elevations,forming an irregular uneven surface.An enlarged fold referred to a fold width≥5 mm in the greater curvature of the corpus.Nodularity was characterized by goosebump-like multiple nodules in the antrum.Diffuse redness was characterized by uniform reddish nonatrophic mucosa in the greater curvature of the corpus.RESULTS A total of 266 gastric cancer patients(mean age,66.7 years;male sex,58.6%;mean body mass index,22.8 kg/m2)were enrolled.Ninety-three patients underwent esophagogastroduodenoscopy for surveillance within 2 years,and 140 had current Helicobacter pylori infection.The mean Kyoto score was 4.54.Fifty-eight cancers were diffuse-type,and 87 cancers had invaded the submucosa.Multivariate analysis revealed that low body mass index(odds ratio 0.88,P=0.02),no surveillance esophagogastroduodenoscopy within 2 years(odds ratio 0.15,P<0.001),endoscopic enlarged folds of gastritis(odds ratio 3.39,P=0.001),and Lauren’s diffuse-type(odds ratio 5.09,P<0.001)were

关 键 词：Gastric cancer GASTRITIS Enlarged fold Endoscopy Kyoto classification 

分 类 号：R735.2[医药卫生—肿瘤]