Higher LNM Rate and Poorer Prognosis of Intestinal Type Compared to Diffuse Type in Early-Onset Early-Stage Gastric Cancer: A Large-Population Based Study

2021 ◽  
Author(s):  
Chao-Tao Tang ◽  
Si-Hai Chen ◽  
Shan Wu ◽  
Youxiang Chen ◽  
Chunyan Zeng
Keyword(s):  
Gastric Cancer ◽  
Early Onset ◽  
Early Stage ◽  
Large Population ◽  
Population Based ◽  
Intestinal Type ◽  
Diffuse Type ◽  
Population Based Study

scholarly journals Higher Lymph Node Metastasis Rate and Poorer Prognosis of Intestinal-Type Gastric Cancer Compared to Diffuse-Type Gastric Cancer in Early-Onset Early-Stage Gastric Cancer: A Retrospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Chao-Tao Tang ◽  
Si-Hai Chen
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Onset ◽  
Early Stage ◽  
Intestinal Type ◽  
Mass Spectrometry Analysis ◽  
Diffuse Type ◽  
Node Metastasis

Background: The incidence of early-onset gastric cancer (GC) that was diagnosed at <50 years is increasing, but there is a knowledge gap on early-onset early-stage GC (EEGC) that was defined as early-onset GC limited to the mucosa or submucosa. Therefore, we comprehensively analysed the clinical features based on Lauren type.Methods: Logistic and Cox analyses were used to investigate risk factors for lymph node metastasis (LNM) and prognosis, respectively. Propensity score matching (PSM) was used to adjust confounding factors. Protein mass spectrometry analysis was used to explore the molecular mechanism of LNM.Result: Our study included 581 patients with EEGC from the Surveillance, Epidemiology, and End Results (SEER) database and 226 patients with EEGC from our own centre. We identified intestinal type, T1b stage, and tumour size (>3 cm) as risk factors for LNM using SEER and our own data. We also found that the prognosis of patients with intestinal-type EEGC was poorer than patients with diffuse-type EEGC, and T1b stage and positive LNM were hazard factors for survival. After analysing the expression of proteins between positive and negative LNM in the intestinal or diffuse type, we found no similar proteins between these groups. The differentially expressed genes (DEGs) in the intestinal type functioned as epithelial cell signalling in Helicobacter pylori. The DEGs in the diffuse type functioned in the tricarboxylic acid cycle (TCA cycle) and oxidative phosphorylation.Conclusion: For EEGC, our study was the first report to demonstrate that the intestinal type was a risk factor for LNM and survival compared to the diffuse type, and the oncogenic expression promoting the occurrence of LNM was different. These findings suggest that clinicians should pay more attention to intestinal-type EEGC than diffuse-type EEGC.

ID: 3523289 PREDICTORS FOR REGRESSION AND PROGRESSION OF INTESTINAL METAPLASIA (IM): A LARGE POPULATION-BASED STUDY FROM LOW PREVALENCE AREA OF GASTRIC CANCER (IM-PREDICTOR TRIAL)

2021 ◽  
Vol 93 (6) ◽  
pp. AB337-AB338
Author(s):  
Natsuda Aumpan ◽  
Bubpha Pornthisarn ◽  
Soonthorn Chonprasertsuk ◽  
Sith Siramolpiwat ◽  
Patommatat Bhanthumkomol ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Intestinal Metaplasia ◽  
Large Population ◽  
Population Based ◽  
Population Based Study ◽  
Low Prevalence

scholarly journals Intestinal-type gastric cancer carries a better prognosis but a higher risk of lymph node metastasis than diffuse-type: a SEER study of nearly 28,000 patients

2020 ◽  
Author(s):  
Chanqiong Zhang ◽  
Guangyu Chen ◽  
Haofeng Hong ◽  
Jinbo Zhu ◽  
Hongyuan Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lymph Node ◽  
Lymph Node Metastasis ◽  
Early Stage ◽  
Intestinal Type ◽  
Seer Database ◽  
Diffuse Type ◽  
Surgical Operation ◽  
Node Metastasis ◽  
The Impact

Abstract Background: The impact of Lauren type, namely intestinal and diffuse types, on prognosis and lymph node metastasis (LNM) for gastric cancer (GC), requires further exploration, since current samples are deficient and the results are inconsistent.We aimed to translate the widely used WHO classifications into Lauren types and analyze the impact with the largest sample size available.Methods: Corresponding Lauren types of the WHO classification system in the Surveillance, Epidemiology, and End Results (SEER) database were included to identify all patients with histological diagnoses of intestinal-type or diffuse-type GC.Results: 4,338 intestinal-type and 22,990 diffuse-type GC were included in our study. Compared with intestinal-type, diffuse-type had a relatively poor prognosis after adjustment for other risk factors (HR, 1.236; P<0.001). Similar to patients with all stages of GC, the prognosis of patients with early diffuse GC was also poor (HR, 1.295; P=0.001). Surgical operation and radiotherapy markedly improved the DSS for patients (P<0.05). To our surprise, the risk of intestinal LNM in all stages of GC was higher than that in the diffuse type (OR=0.891; P=0.036). Although, there was no positive correlation between LNM and Lauren’s GC (OR=1.096; P=0.467) in early stage.Conclusion: Intestinal-type GC carries a better prognosis but a higher risk of LNM than diffuse-type. Patients with intestinal-type GC are likely to gain a greater benefit from receiving surgical treatment, but it is worth noting that clinicians should pay more attention to their lymphatic metastasis.*Contributed equally.The first author: Chanqiong Zhang, Guangyu Chen

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