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©The Author(s) 2024.
World J Gastroenterol. Apr 14, 2024; 30(14): 1990-2005
Published online Apr 14, 2024. doi: 10.3748/wjg.v30.i14.1990
Published online Apr 14, 2024. doi: 10.3748/wjg.v30.i14.1990
Table 1 Clinical characteristics of gastric mucosal tumors with different degrees of differentiation, n (%)
LGIN (n = 96) | HGIN (n = 100) | Differentiated-type (n = 89) | Undifferentiated-type (n = 16) | P value | |
Gender | 0.013 | ||||
Male | 61 (63.5)a | 76 (76.0)a,b | 73 (82.0)b | 9 (56.3)a,b | |
Female | 35 (36.5)a | 24 (24.0)a,b | 16 (18.0)b | 7 (43.8)a,b | |
Age (yr) (range) | 57 (55-59)a | 63 (61-65)b | 63 (61-65)b | 64 (59-68)a,b | < 0.001 |
Comorbidity | |||||
Diabetes | 6 (6.3) | 15 (15.0) | 9 (10.1) | 0 (0.0) | 0.108 |
Hypertension | 17 (17.7) | 31 (31.0) | 19 (21.3) | 4 (25.0) | 0.161 |
Cardiovascular disease | 5 (5.2) | 8 (8.0) | 9 (10.1) | 2 (12.5) | 0.572 |
Liver cirrhosis | 5 (5.2) | 1 (1.0) | 2 (2.2) | 0 (0.0) | 0.265 |
Chronic pulmonary disease | 2 (2.1) | 6 (6.0) | 1 (1.1) | 0 (0.0) | 0.175 |
Reflux esophagitis | 15 (15.6) | 12 (12.0) | 11 (12.4) | 3 (18.8) | 0.794 |
Barrett’s esophagus | 4 (4.2) | 2 (2.0) | 1 (1.1) | 0 (0.0) | 0.489 |
Atrophic gastritis | 72 (75.0)a | 93 (93.0)b | 84 (94.4)b | 13 (81.3)a,b | < 0.001 |
Previous gastric cancer | 1 (1.0) | 0 (0.0) | 2 (2.2) | 0 (0.0) | 0.461 |
Smoking history | 26 (27.1)a | 49 (49.0)b | 45 (50.6)b | 6 (37.5)a,b | 0.004 |
Drinking history | 24 (25.0) | 31 (31.0) | 24 (27.0) | 3 (18.8) | 0.673 |
Family history | 15 (15.6) | 11 (11.0) | 19 (21.3) | 0 (0.0) | 0.074 |
Table 2 Pathological characteristics of gastric mucosal tumors with different degrees of differentiation, n (%)
LGIN (n = 96) | HGIN (n = 100) | Differentiated-type (n = 89) | Undifferentiated-type (n = 16) | P value | |
Size (cm) (range) | 2.7 (2.2-3.7)a | 3.2 (2.4-3.7)a,b | 3.7 (2.7-4.2)b | 3.5 (2.8-4.6)b | 0.001 |
Location | 0.006 | ||||
Top 1/3 | 19 (19.8) | 30 (30.0) | 33 (37.1) | 2 (12.5) | |
Medium 1/3 | 10 (10.4) | 22 (22.0) | 13 (14.6) | 5 (31.3) | |
Lower 1/3 | 67 (69.8)a | 48 (48.0)b | 43 (48.3)b | 9 (56.3)a,b | |
Paris classification | < 0.001 | ||||
0-I | 24 (25.0)a | 3 (3.0)b | 3 (3.4)b | 2 (12.5)a,b | |
0-IIa | 19 (19.8) | 14 (14.0) | 11 (12.4) | 0 (0.0) | |
0-IIb | 9 (9.4) | 11 (11.0) | 9 (10.1) | 0 (0.0) | |
0-IIc | 20 (20.8)a | 39 (39.0)b | 39 (43.8)b | 8 (50.0)a,b | |
0-III | 1 (1.0) | 1 (1.0) | 1 (1.1) | 0 (0.0) | |
0-IIa+ IIc | 23 (24.0) | 32 (32.0) | 26 (29.2) | 6 (37.5) | |
Invasion depth | < 0.001 | ||||
M1M2 | 96 (100.0)a | 100 (100.0)a | 43 (48.3)b | 5 (31.3)b | |
M3 | 0 (0.0)a | 0 (0.0)a | 37 (41.6)b | 6 (37.5)b | |
SM1 | 0 (0.0)a,b | 0 (0.0)b | 6 (6.7)a,c | 2 (12.5)c | |
SM2 | 0 (0.0)a | 0 (0.0)a | 3 (3.4)a,b | 3 (18.8)b | |
Presence of H. pylori | 37 (48.7) | 38 (52.8) | 32 (56.1) | 4 (40.0) | 0.727 |
Presence of ulceration | 6 (6.3) | 6 (6.0) | 7 (7.9) | 4 (25.0) | 0.058 |
Table 3 The white light endoscopic manifestations of gastric mucosal tumors with different degrees of differentiation, n (%)
LGIN (n = 96) | HGIN (n = 100) | Differentiated-type (n = 89) | Undifferentiated-type (n = 16) | P value | |
Nodularity | 65 (67.7) | 65 (65.0) | 60 (67.4) | 11 (68.8) | 0.974 |
Redness | 51 (53.1) | 50 (50.0) | 60 (67.4) | 7 (43.8) | 0.059 |
Whiteness | 7 (7.3) | 5 (5.0) | 2 (2.2) | 0 (0.0) | 0.324 |
White moss | 10 (10.4) | 14 (14.0) | 15 (16.9) | 2 (12.5) | 0.646 |
Spontaneous bleeding | 3 (3.1)a | 11 (11.0)a,b | 18 (20.2)b | 0 (0.0)a,b | 0.001 |
Abnormal fold | 3 (3.1)a | 1 (1.0)a | 6 (6.7)a,b | 4 (25.0)b | < 0.001 |
Poor peristalsis | 2 (2.1)a,b | 1 (1.0)b | 9 (10.1)a,c | 3 (18.8)c | < 0.001 |
Table 4 Magnified endoscopy with narrow-band imaging manifestations of gastric mucosal tumors with different degrees of differentiation, n (%)
Table 5 Endoscopic submucosal dissection efficacy and safety of gastric mucosal tumors with different degrees of differentiation, n (%)
LGIN (n = 96) | HGIN (n = 100) | Differentiated-type (n = 89) | Undifferentiated-type (n = 16) | P value | |
Absolute indication | 91 (94.8)a,b | 97 (97.0)b | 77 (86.5)a | 2 (12.5)c | < 0.001 |
En bloc resection | 93 (96.9) | 98 (98.0) | 88 (98.9) | 16 (100.0) | 0.729 |
Complete resection | 88 (91.7) | 90 (90.0) | 79 (88.8) | 13 (81.3) | 0.630 |
Curative resection | 83 (86.5)a | 87 (87.0)a | 70 (78.7)a | 2 (12.5)b | < 0.001 |
Complication | 5 (5.2)a | 5 (5.0)a | 3 (3.4)a | 4 (25.0)b | 0.007 |
Bleeding | 3 (3.1)a,b | 1 (1.0)b | 2 (2.2)b | 3 (18.8)a | 0.002 |
Perforation | 2 (2.1) | 4 (4.0) | 2 (2.2) | 1 (6.3) | 0.710 |
Stenosis | 0 (0.0)a | 0 (0.0)a | 0 (0.0)a | 1 (6.3)b | < 0.001 |
Table 6 Follow-up results of gastric mucosal tumors with different degrees of differentiation, n (%)
LGIN (n = 96) | HGIN (n = 100) | Differentiated-type (n = 89) | Undifferentiated-type (n = 16) | P value | |
BMI (range) | 23.87 (23.19-24.54)a | 23.09 (22.41-23.77)a,b | 22.37 (21.71-23.02)b | 21.44 (20.08-22.79)b | 0.003 |
Adverse outcome | 8 (8.3)a | 6 (6.0)a | 7 (7.9)a | 6 (37.5)b | < 0.001 |
Recurrence | 5 (5.2) | 6 (6.0) | 6 (6.7) | 2 (12.5) | 0.734 |
Metastasis | 3 (3.1)a,b | 0 (0.0)b | 2 (2.2)b | 3 (18.8)a | < 0.001 |
Multiple primary cancer | 24 (25.0) | 15 (15.0) | 15 (16.9) | 4 (25.0) | 0.276 |
Table 7 Multivariate analysis of time-related factors of adverse outcomes such as recurrence, metastasis and death
Variable | Category | P value | Hazard ratio | 95%CI |
Differentiation degree | Undifferentiated-type | 0.004 | 5.066 | 1.688-15.200 |
LGIN | 1 | |||
White moss | Yes | < 0.001 | 7.187 | 3.122-16.546 |
No | 1 | |||
Complete resection | No | 0.012 | 3.658 | 1.337-10.010 |
Yes | 1 | |||
Multiple primary cancer | Yes | 0.030 | 2.462 | 1.090-5.562 |
No | 1 |
Table 8 Multivariate analysis of factors associated with incomplete resection
Variable | Category | P value | Odds ratio | 95%CI |
Invasion depth | M1M2 | 0.004 | 11.200 | 2.120-59.163 |
M3 | 0.032 | 7.600 | 1.192-48.437 | |
SM2 | - | 1 | - |
Table 9 Multivariate analysis of factors associated with noncurative resection
Variable | Category | P value | Odds ratio | 95%CI |
Peristaltic condition | Poor | 0.009 | 0.185 | 0.052-0.653 |
Normal | 1 | |||
Microsurface pattern | Irregular | 0.043 | 0.410 | 0.173-0.972 |
Regular | 1 | |||
Ulceration | Yes | < 0.001 | 0.073 | 0.026-0.207 |
No | 1 |
Table 10 Multivariate analysis of complications related factors
Variable | Categor | P value | Odds ratio | 95%CI |
Histologic type | Signet ring cell (sig) | 0.032 | 32.627 | 1.357-784.415 |
Mucinous (muc) | 0.006 | 49.855 | 3.051-814.724 | |
LGIN | - | 1 | - | |
Paris classification | 0-III | 0.020 | 30.406 | 1.695-545.565 |
0-I | 1 |
Table 11 Multivariate analysis of factors related to postoperative pathological degradation
Variable | Category | P value | Odds ratio | 95%CI |
Location | Lower 1/3 | 0.037 | 2.399 | 1.055-5.455 |
Top 1/3 | 1 | |||
Barrett’s esophagus | Yes | 0.026 | 7.805 | 1.277-47.689 |
No | 1 |
Table 12 Multivariate analysis of factors related to postoperative pathological upgrading
Variable | P value | Odds ratio | 95%CI |
BMI | 0.022 | 0.906 | 0.833-0.986 |
- Citation: Zhu HY, Wu J, Zhang YM, Li FL, Yang J, Qin B, Jiang J, Zhu N, Chen MY, Zou BC. Characteristics of early gastric tumors with different differentiation and predictors of long-term outcomes after endoscopic submucosal dissection. World J Gastroenterol 2024; 30(14): 1990-2005
- URL: https://www.wjgnet.com/1007-9327/full/v30/i14/1990.htm
- DOI: https://dx.doi.org/10.3748/wjg.v30.i14.1990