title: Evaluation of the morphology of submucosal tumor invasion and its volume in early gastric cancer.
abstract: BACKGROUND
  The aim of the present study was to evaluate the clinical importance of the morphology of submucosal tumor invasion and its volume in early gastric cancer.
  
  
  METHODS
  The subjects were 92 patients with a single lesion of early gastric cancer, who underwent gastrectomy with dissection of lymph nodes, and in whom the lesion was histologically-diagnosed as early gastric cancer with submucosal invasion. The volume of lesions (Vsm, S: < 50 mm3, L: > = 50 mm3) was determined by reconstructing submucosal lesions by the surface rendering method using pathological tissue sections (mean, 3.6 sections/lesion). The relationships between the volume of lesions and lymph node metastasis and between conventional clinicopathological parameters and lymph node metastasis were evaluated.
  
  
  RESULTS
  Lymph node metastasis was observed in 18 patients (20%). The depth of submucosal invasion was 1.7 +/- 1.4 mm (mean +/- S.D.; range, 0.2-7.5 mm). sm1 (depth of submucosal tumor invasion < 0.5 mm) was observed in 11 patients (12%), and sm2 (depth of submucosal tumor invasion > = 0.5 mm) in 81 patients (88%). The mean Vsm was 104.1 +/- 215.4 mm3 (0.4-1,730.5 mm3). Fifty-seven patients (62.0%) were in group S, and 35 patients (38.0%) in group L. There was a significant difference between lymph node metastasis and Vsm (S vs. L) alone (p = 0.006). Logistic regression analysis also demonstrated that Vsm alone was correlated with lymph node metastasis (p = 0.005; odds ratio, 1.27; 95% confidence interval, 0.074-0.401).
  
  
  CONCLUSIONS
  The volume of submucosal lesions in early gastric cancer is important for evaluating lymph node metastasis.
authors.affiliation: Department of Surgery, Ozawa Hospital, 1-1-17, Honchou, Odawara-shi, Kanagawa 250, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsuzaki
authors.forename: Shiro
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Akira
authors.initials: A
authors.lastname: Kakita
mesh_terms: D005069:Evaluation Studies as Topic; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D015994:Incidence; D008207:Lymphatic Metastasis / Q000473:pathology*; D009361:Neoplasm Invasiveness; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000556:secondary*