표층팽창형과 소형 조기위암의 임상병리학적 분석
Clinicopathological Analysis of Superficial Spreading and Small-sized Types of Early Gastric Cancer
오승엽, 구범환, 민병욱, 김종석, 목영재, 김승주, 김호일, 류근원,
소속 상세정보
오승엽 ( Oh Seung-Yeop )
고려대학교 의과대학 외과학교실
구범환 ( Koo Bum-Hwan )
고려대학교 의과대학 외과학교실
민병욱 ( Min Byung-Wook )
고려대학교 의과대학 외과학교실
김종석 ( Kim Chong-Suk )
고려대학교 의과대학 외과학교실
목영재 ( Mok Young-Jae )
고려대학교 의과대학 외과학교실
김승주 ( Kim Seung-Joo )
고려대학교 의과대학 외과학교실
김호일 ( Kim Ho-Il )
고려대학교 의과대학 외과학교실
류근원 ( Ryu Keun-Won )
국립암센터
KMID : 0371320030640030212
Abstract
PURPOSE: The superficial spreading type of early gastric cancer has different clinicopathologic features from other types of early gastric cancers in terms of its invasiveness and lymph node metastases. Therefore, the clinicopathological features of the superficial spreading type and the small-sized early gastric cancers, were analyzed, and the influence of those features on the surgical procedures and prognosis was investigated.
METHODS: During an 8-year period (1992~1999), 22 superficial spreading early gastric cancers were analyzed with respect to the macroscopic type, lymph node metastasis, and the surgical procedure, and compared with those of 219 small-sized early gastric cancers. The superficial spreading type was defined as a lesion more than 5×5 cm and small-sized type, as a lesion less than 2×2 cm. The survival rate was analyzed using the Kaplan-Meier method and those patients who died of diseases unrelated to gastric cancer were excluded. Other statistical analyses were performed using the chi-square test.
RESULTS: Twenty two out of 369 (6%) early gastric cancers were the superficial spreading type. The incidence of a LN metastasis was 12.3% in early gastric cancer, 8.7% in the small-sized type, and 27.3% in the superficial spreading type. The incidence of a LN metastasis was greater in the superficial spreading type than in the small-sized type (P=0.006). The location of the lesions, the histological type, and the depth of the invasion in the superficial spreading and small-sized early gastric cancers were similar. There was difference in the method of surgery and the extent of the lymph node dissection between two groups.
CONCLUSION: Because the incidence of a lymph node metastasis is higher in the superficial spreading type than in the small-sized early gastric cancer, a wide resection with an extensive lymph node dissection appears to be appropriate treatment for the superficial spreading type of early gastric cancer.
키워드
조기 위암;표층팽창형;소형;임상병리학적 특성
Early gastric cancer;Superficial spreading type;Small-sized type;Clinicopathologic features
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