Abstract:
Objective To investigate the clinicopathological characteristics and relevance of main and minor lesions of synchronous multiple gastric cancer and gastric high-grade intraepithelial neoplasia.
Methods We retrospectively reviewed 56 patients with synchronous multiple gastric cancer and gastric high-grade intraepithelial neoplasia who had been treated with operation and endoscopic submucosal dissection. Their clinicopathologic characteristics were summarized, and the correlation between main and minor lesions were analyzed.
Results Among the 56 patients, with a mean age of (63.82±11.88) years, 75% were men whereas 25% were women. Twenty-five (44.64%) patients had mucosal atrophy. The depth of tumor invasion in main and minor lesions was mainly stage T1. The size of main and minor lesions showed a positive correlation (r=0.797, P < 0.001). The pathologic type of main and minor lesions demonstrated a moderately significant positive correlation (P=0.007). The endoscopic classification between major and minor lesions had a statistically significant consistency (P < 0.001). The comparison of location between main and minor lesions showed a correlation:the correlation coefficient of the vertical position was 0.484 (P=0.002) and that of the horizontal position was 0.535 (P=0.007). Main lesions in multifocal gastric cancer or high-grade gastric intraepithelial neoplasia differed from single-focal gastric cancer or high-grade gastric intraepithelial neoplasia in terms of lymphatic metastasis, the TNM stage, and mucosal atrophy.
Conclusions Old men who had lesions combined with mucosal atrophy were considered as the high-risk group among patients with synchronous multiple gastric cancer and gastric high-grade intraepithelial neoplasia. Therefore, clinicians must keep a high grade of suspicion and make careful observations during the endoscopic examination, considering the correlation between main and minor lesions, in order to avoid any misdiagnosis.