title: Differences in Clinicopathology of Early Gastric Carcinoma between Proximal and Distal Location in 438 Chinese Patients.
abstract: Early gastric carcinoma (EGC) in Chinese patients remains poorly understood and endoscopic therapy has not been well established. Here, we compared endoscopic and clinicopathologic features between early proximal gastric carcinoma (PGC, n = 131) and distal gastric carcinoma (DGC, n = 307) in consecutive 438 EGCs diagnosed with the WHO criteria. By endoscopy, PGCs showed protruding and elevated patterns in 61.9%, while depressed and excavated patterns in 33.6%, which were significantly different from those (32.6% and 64.5%) in DGCs. PGCs were significantly smaller (1.9 cm in average, versus 2.2 cm in DGCs), invaded deeper (22.9% into SM2, versus 13% in DGCs), but had fewer (2.9%, versus 16.7% in DGCs) lymph node metastases. Papillary adenocarcinoma was significantly more frequent (32.1%, versus 12.1% in DGCs), as were mucinous and neuroendocrine carcinomas, carcinoma with lymphoid stroma (6.9%, versus 1.6% in DGCs); but poorly cohesive carcinoma was significantly less frequent (5.3%, versus 35.8% in DGCs). The overall 5-year survival rate was 92.9% in EGCs, and PGC patients showed shorter (42.4 months, versus 48.3 in DGCs) survival. Papillary and micropapillary adenocarcinomas and nodal metastasis were independent risk factors for worse survival in EGCs. EGCs in Chinese were heterogeneous with significant differences in endoscopy and clinicopathology between PGC and DGC.
authors: Department of Pathology, the Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing 0210008, Jiangsu Province, P.R.China.|Department of Pathology and laboratory medicine, Veterans Affairs Boston Healthcare System and Harvard Medical School, 1400 VFW Parkway, West Roxbury, MA 02132, USA.
authors: Qin
authors: Q
authors: Huang
authors: Department of Gastroenterology, the Affiliated Drum Tower Clinical Medical School, Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, 0210008, Jiangsu Province, P.R.China.
authors: Cheng
authors: C
authors: Fang
authors: Department of Pathology, the Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing 0210008, Jiangsu Province, P.R.China.
authors: Jiong
authors: J
authors: Shi
authors: Department of Pathology, the Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing 0210008, Jiangsu Province, P.R.China.
authors: Qi
authors: Q
authors: Sun
authors: Department of Pathology, the Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing 0210008, Jiangsu Province, P.R.China.
authors: Hongyan
authors: H
authors: Wu
authors: Department of Surgery, Veterans Affairs Boston Healthcare System and Harvard Medical School, 1400 VFW Parkway, West Roxbury, MA 02132, USA.
authors: Jason S
authors: JS
authors: Gold
authors: Department of Gastroenterology, Veterans Affairs Boston Healthcare System and Harvard Medical School, 1400 VFW Parkway, West Roxbury, MA 02132, USA.
authors: H Christian
authors: HC
authors: Weber
authors: Department of Pathology, the Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing 0210008, Jiangsu Province, P.R.China.
authors: Wenyan
authors: W
authors: Guan
authors: Department of Pathology, the Nanjing Drum Tower Hospital, No. 321 Zhongshan Road, Nanjing 0210008, Jiangsu Province, P.R.China.
authors: Yifen
authors: Y
authors: Zhang
authors: Department of Gastroenterology, the Affiliated Drum Tower Clinical Medical School, Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, 0210008, Jiangsu Province, P.R.China.
authors: Chenggong
authors: C
authors: Yu
authors: Department of Gastroenterology, the Affiliated Drum Tower Clinical Medical School, Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, 0210008, Jiangsu Province, P.R.China.
authors: Xiaoping
authors: X
authors: Zou
authors: Department of Gastroenterology, Veterans Affairs Boston Healthcare System and Harvard Medical School, 1400 VFW Parkway, West Roxbury, MA 02132, USA.
authors: Hiroshi
authors: H
authors: Mashimo
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D044466:Asian People; D002681:China; D003710:Demography; D004724:Endoscopy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011182:Postoperative Care; D013270:Stomach / Q000473:pathology* / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery