Characteristics Of Multiple Early Gastric Cancer And/or Gastric High-Grade Intraepithelial Neoplasia

ObjectivesThe purpose of this study was to evaluate the clinical characteristics of multiple early gastric cancer and/or gastric high-grade intraepithelial neoplasia treated by endoscopic submucosal dissection.MethodsTwenty-three multiple early gastric cancer patients in hospitalization treated by endoscopic submucosal dissection(ESD)from January 2008 to June 2019 were enrolled in this study.The medical records of these patients were collecting,including age,gender,smoking history,alcohol drinking and so on.We also collect macroscopic type,tumor location,Helicobacter pylori infection and tumor markers before ESD.Pathological type,histological differentiation and depth of invasion were also analyzed.Statistical analysis was performed using SPSS 23.0 software.ResultsA total of 23 multiple early gastric cancer and gastric high-grade intraepithelial neoplasia patients(mean age 64±5.6 years,73.9% male)were enrolled in this study.Multiple early gastric cancer and gastric high-grade intraepithelial neoplasia accounted for 4.9 percent of all cases,in which 19(4.1%)cases were synchronous multiple cancers and 4(0.8%)cases were metachronous multiple cancers.Lesions of synchronous and metachronous MEGC groups did not differ in age,gender,smoking history,alcohol drinking family history of tumors,Helicobacter pylori infection,mucosal background atrophy and intestinal metaplasia respectively(P>0.05).The main and minor lesions of SMEGC showed the same vertical locations in 30.4% of cases.The vertical location of major and minor lesions of MEGC were correlated(r=0.395,P=0.034).With respect to the macroscopic type,the association of macroscopic type was statistically significant at 65.2% for both the main and minor lesions of MEGC to share the same type(r=0.590,P=0.015).In the MEGC patients,the association of invasion depth was statistically significant at 82.6% for both the main and minor lesions of MEGC to share the same depth(r=0.455,P=0.014).The association of Histology type was statistically significant at 65.2% for both the main and minor lesions of MEGC to share the same type(r=0.736,P<0.001).ConclusionsMultiple early gastric cancer and/or gastric high-grade intraepithelial neoplasia are located in proximity.Pathologic types tended to be low grade malignancy.Macroscopic type,histology type and invasion depth of two lesions were significantly correlated.When detecting early gastric cancer,we should detect the stomach carefully combined with the characteristics.That can help us to improve the diagnosis of MEGC.