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Time-dependent morphologic change in depressed-type early gastric cancer

Cited 7 time in Web of Science Cited 9 time in Scopus
Authors
Im, Jong Pil; Kim, Sang Gyun; Kim, Joo Sung; Jung, Hyun Chae; Song, In Sung
Issue Date
2009-11
Publisher
SPRINGER
Citation
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES; Vol.23 11; 2509-2514
Keywords
Antisecretory medicationUlcerEarly gastric cancerMalignant cycle
Abstract
Background Depressed-type early gastric cancer (EGC) is known to repeat improvement and exacerbation of ulceration during its natural Course, forming a "malignant cycle." However, it is difficult to observe the malignant cycle of EGC in clinical practice, and little is known about the clinicopathologic factors associated with this cycle. This Study aimed to evaluate the malignant cycle of EGC and to determine the clinicopathologic factors associated with the time-dependent morphologic change of EGC. Methods The medical records of EGC patients treated at the Seoul National University Hospital were retrospectively reviewed with two or more comparable endoscopic photos taken between March 1999 and December 2005. The ulcer stages in EGC were classified by the gastric ulcer stage system and evaluated for time-dependent morphologic changes according to the relevant factors. Results In this study, 231 cases of depressed-type EGC were evaluated. At the follow-up endoscopy after a median interval of 23 days, a change in ulcer stage was observed in 66 patients (29%), with improvement in 45 patients (20%) and exacerbation in 21 patients (9%). 017 the 177 patients who demonstrated an active or healing stage, 45 (25%) showed improvement and 10 (6%) exhibited exacerbation. The multivariate analysis showed that the usage of antisecretory medications, mucosal cancer, and a longer interval between the two endoscopic examinations were the factors that had a significant association with improvement of the ulcer stage. Conclusions The malignant cycle was frequently observed in depressed-type EGC. The improvement of ulceration in EGC was time dependent and associated with the usage of antisecretory medication and the depth of C, invasion.
ISSN
0930-2794
Language
English
URI
https://hdl.handle.net/10371/76427
DOI
https://doi.org/10.1007/s00464-009-0434-2
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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