Endoscopy And Clinicopathologic Analysis Of Early Esophageal Carcinoma And Gastric Cancer

The esophageal carcinoma and gastric cancer are the primary fetal diseases of digestive tract in the worldwide, which have higher incidence rate and mortality rate, and they threat our people’s health seriously. According to a large number of epidemiological data show that their prognosis of advanced cancer are poor, the rate of 5-year survival rate is less than 20%;while prognosis of early stage of them are good, the rate of 5-year survival rate is up to 90%. Therefore, they are diagnosed early and accurately, which is of great importance to improve poor prognosis and reduce mortality. The ways of diagnosis in upper gastrointestinal carcinoma mainly depend on endscopic examination,(including ordinary gastroscopy, endoscopic ultrasonography, magnifying endoscopy, NBI and chromoendoscopy, etc). Nevertheless, endoscopy, surgery combined with histopathological examination is always the gold standard for the diagnosis of the upper gastrointestinal carcinoma. Currently, therapy of the upper gastrointestinal carcinoma still relies on surgery.But as developing of the endoscopic therapy extensively and appling maturely, expecially endoscope mucosal resection(EMR) and endoscope submucosal dissection(ESD), more and more patients choose to select endoscope resection. Selecting of surgery therapy and prognosis mainly rest upon depth of invasion and lymph node metastasis. This paper gathered data of endoscopic appearance and clinicopathologic characteristics of early eaophageal carcinoma and early gastric carcinoma,calculating early detection rate and analyzing relation between depth of invasion and node metastasis with them in order to improving the recognition of early lesions and supplying potential basis of endoscopic treatment.Based on above, we collected data in our digestive departments’ endoscopic center form June 2011 to May 2013 that detected by endoscopy and comfired by post-operation or post-ESD biosy, excluding cases of metastatic carcinoma, post-operative carcinoma and incomplete information. Eventually we included 40 cases of early esophageal carcinoma and 105 cases of early gastric cancer in the statistic. Calculate endoscopic early detection rate in the recent 3 years and discuss their endocopic character and pathology. 1、 Endoscopic appearanece and analysis of clinical pathology of early esophageal Objective: Calculate endoscopic early detection rate in recent there years and analysis the results of preoperative endoscopy and postoperative pathology of 40 cases of early esophageal carcinoma, improving recognition of early lesions and discussing the relation between endoscopic appearance, clinical pathology and it’s depth of invasion. Methods: We collected 40 cases of early esophageal carcinoma that were detected by preoperative endoscopy and were confirmed by postoperative or post-ESD biopsy. Results:The rate of early detection rate in recent there years were 14.08%, 14.22% and 10.31% respectively. There were 40 cases of early esophageal carcinoma, of which were 23 men and 17 women with ages ranged from 49 to 75. The peak years of invasive age were from 60 to 64 years. 42.5% of patients go to hospital not because of the esophageal symptoms. The ratio of the midpiece esophageal was 72.5%. The ratio of the lesion size with 1 to 3 centimeters was 62.5%. As for the endoscopic classification, the percentage of type II was 62.5%. There was no correlation between gender, age, size and position with infiltration depth. Endoscopic type, differentitation degree and depth of invasion were obviously relevant. Type II was given priority to with mucous layer and Mixture type was given priority to with sub mucosa. Highly differentiated squamous carcinoma often involves in mucosal layer, and poorly differentiated squamous carcinoma often invades sub mucosal mucous membrane layers. Differentiated degree was independent risk factor for lymph node metastasis. Conclusion: In this region,the ratio of male/female was close. The lesions mainly occured in middle and distal fractures of esophageal. The main macroscopical type was II. Screening for asymptomatic crowd who is more than 50 years is very necessary.We should pay attention to endocopic endoscopic classification and differentiated degree of tissue, which hints the depth of invation. 2、 Endoscopic appearanece and analysis of clinical pathology of early gastric carcinomaObjective: Calculate endoscopic early detection rate in recent there years. Analysis the results of preoperative endoscopy and postoperative pathology of 105 cases of early gastric carcinoma, improving recognition of early lesions and discussing the relation between endoscopic appearance, clinical pathology and its’ lymph node metastasis.Methods: We collected 105 cases of early gastric carcinoma that were dectected by preoperative endoscopy and were confirmed by postoperative biopsy.Results: The ratio of early diagnosis in three years are 14.08%、14.22%、10.31% respectively.Of the 105 cases(84 men and 21 women), the age ranged from 19 to 89 years old. The sex ration is 4 to 1.The peak years of invasive age were from 45 to 59. There were 84 men, of which were 71 of Han nationality and 23 of Hui nationality, while there were 21 women, of which were 20 of Han nationality and 1 of Hui nationality. Different gender and age distribution in ethnic groups have no difference. The antrum was the most location of EGC(55.23%), then body of stomach(26.67%), followed by cardia gastric carcinoma(16.19%). The ratio of size which is between 1 and 3 centimeters is 80%. The ratio of main macroscopical type II was 80%.Classification of histology was given priority to with adenocarcinoma(89.52%). The ratio of lesions comebined with ulcer is 72.38%. The ratios of differentiated and undifferentiated type were 43.81% and 55.77% respectively. Intra-mucosal carcinoma were in 64 patients(60.95%), submucosal carcinoma were in 41 cases(39.04%). 12/105 cases(11.4%) were histologically shown to have lymph node metastasis. Tumor size, differentiated degree and depth of submucosal invasion were independent risk factors for LN metastasis.Conclusion: Male patients were obviously more than female in early gastric cancer. The peak years of invasive age were from 45 to 59. Different gender and age distribution in ethnic groups have no difference. The lesions mainly occurred in anturm of stomach and the size commonly more than 2 centimeters, undifferentiated carcinoma and submucosal invasion should have a further EUS ditection and cautious endocopic resection because of higher LN metastasis.