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. 2023 Aug;149(9):5781-5790.
doi: 10.1007/s00432-022-04536-7. Epub 2022 Dec 30.

Clinicopathological features of endoscopically treated early gastric cancer with lymphovascular infiltration

Koji Takano  1 , Keiichi Ashikari  1 , Shigeki Tamura  1 , Noboru Misawa  1 , Tomohiro Takatsu  1 , Tsutomu Yoshihara  1 , Takashi Nonaka  1 , Jun Arimoto  2 , Atsuhiko Sakamoto  3 , Hideyuki Chiba  2 , Satoshi Fujii  4 , Atsushi Nakajima  1 , Takuma Higurashi  5
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Clinicopathological features of endoscopically treated early gastric cancer with lymphovascular infiltration

Koji Takano et al. J Cancer Res Clin Oncol. 2023 Aug.

Abstract

Purpose: Lymphovascular infiltration (LVI) may play a critical role in radicality and prognostic assessment of early gastric cancer (EGC). However, risk factors for LVI in endoscopically resected EGC remain unknown. This study evaluated the clinicopathological characteristics and prognoses of patients who underwent endoscopic resection of EGC to identify potential risk factors of LVI.

Methods: A cross-sectional study of patients who received gastric endoscopic submucosal dissection between February 1, 2012, and December 31, 2019, at two institutions was conducted. Among 1,462 lesions, 943 met the criteria for radical treatment considering features other than LVI and were included. The lesions were classified based on the presence of LVI. The clinicopathological characteristics of the two groups were compared.

Results: LVI was detected in 17 lesions (1.8%). The positivity rates of LVI were 0.7% (7/903) for intramucosal cancer and 25% (10/40) for submucosally invasive cancer. The LVI positivity rate was significantly higher for mixed-type cancer (lesions containing differentiated and undifferentiated-type carcinoma) than for non-mixed-type cancer (35.3 vs. 2.8%; P < 0.001) and for submucosally invasive cancer than for intramucosal cancer (58.8 vs. 3.2%; P < 0.001). In the multivariate logistic regression analysis, independent risk factors for LVI were mixed-type cancer (odds ratio; 95% confidence interval: 23.9; 5.0-115; P < 0.001) and submucosal invasion (58.7; 16.0-215; P < 0.001).

Conclusions: Mixed-type cancer and submucosal invasion were risk factors for LVI in endoscopically resected EGC. These factors may play a critical role in the radicality and prognostic assessment of EGC.

Keywords: Early gastric cancer; Endoscopic submucosal dissection; Lymphovascular infiltration; Mixed-type cancer; Submucosal invasion.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Flowchart of lesion enrollments. Among the 1462 lesions, the final analysis was performed with 943 lesions that met the criteria for radical treatment considering features other than lymphovascular infiltration
See this image and copyright information in PMC

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