Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2024; 16(9): 3898-3904
Published online Sep 15, 2024. doi: 10.4251/wjgo.v16.i9.3898
Clinical characteristics of patients with early gastric prematurity cancer and analysis of complications by endoscopic resection
Hong Zhao, Xiang-Yu Shi, Li-Li Lv, Yan-Zong Lai, Xiao-Xiao Bao, Jian-Wen Hu
Hong Zhao, Li-Li Lv, Yan-Zong Lai, Jian-Wen Hu, Department of Gastroenterology, Dongyang People’s Hospital, Dongyang 322100, Zhejiang Province, China
Xiang-Yu Shi, Department of Gastroenterology, Yiwu Tianxiang Medical East Hospital, Yiwu 322100, Zhejiang Province, China
Xiao-Xiao Bao, Department of Pathology, Dongyang People’s Hospital, Dongyang 322100, Zhejiang Province, China
Author contributions: Zhao H designed the research study; Zhao H, Shi XY, Lv LL, Lai YZ, Bao XX, and Hu JW performed the primary literature review and data extraction; Zhao H, Shi XY, Lv LL, Lai YZ, Bao XX, and Hu JW analyzed the data and wrote the manuscript; Zhao H revised the manuscript for important intellectual content; all authors have read and approved the final version.
Institutional review board statement: This study was reviewed and approved by the Science and Research Office of Dongyang People’s Hospital.
Informed consent statement: All study participants or their legal guardians provided written informed consent for personal and medical data collection before study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Wen Hu, PhD, Chief Physician, Department of Gastroenterology, Dongyang People’s Hospital, East 6 Ward, No. 60 Wuning West Road, Dongyang 322100, Zhejiang Province, China. hujw1964@126.com
Received: July 24, 2024
Revised: August 7, 2024
Accepted: August 9, 2024
Published online: September 15, 2024
Processing time: 46 Days and 21.2 Hours
Abstract
BACKGROUND

Gastric cancer, a prevalent malignancy, poses a severe threat to the health of residents in China. Timely intervention in early stages can extend patients’ survival.

AIM

To analyze clinical characteristics of patients with early gastric cancer and efficacy and risk of complications associated with endoscopic resection.

METHODS

This study included 175 patients with early gastric cancer treated at our hospital, with no restrictions on sex or age. General data, pathological information, and endoscopic biopsy results were obtained. The clinical characteristics of early gastric cancer were analyzed, and endoscopic resection was performed. Postoperative efficacy and incidence of complications were monitored. Statistical analysis was performed using SPSS 26.0 and GraphPad Prism 8.0 software.

RESULTS

A total of 175 patients with early gastric cancer were included, with 75.43% (n = 132) males and 24.57% (n = 43) females. 38.29% (n = 67) and 35.43% (n = 62) of patients had a history of smoking and alcohol consumption, respectively. Comorbidities included diabetes (8.57%, n = 15), coronary heart disease (10.29%, n = 18), and hypertension (43.43%, n = 76), which was highly prevalent. A history of abdominal surgery and family history of digestive system cancer accounted for 21.14% and 17.14%, respectively. The most common lesion location was the antral part of the stomach (52.00%, n = 91), followed by the gastric angle, body, and fundus. The pathological types were predominantly high-grade intraepithelial neoplasia (28.00%, n = 49) and well-differentiated adenocarcinoma (26.86%, n = 47), followed by moderately differentiated adenocarcinoma, high-moderately differentiated adenocarcinoma, and moderate-lowly differentiated adenocarcinoma. 89.14% of the patients had intestinal metaplasia and 85.14% had atrophy. After endoscopic resection, re-examination revealed that 13 patients had cancer cells at the tissue margin, with a positive margin rate of 7.43%. Postoperative complications included no cases of gastrointestinal obstruction, but incisional infection (2.86%, n = 5), gastric perforation (1.14%, n = 2), and gastric bleeding (4%, n = 7) were present, with an overall incidence of 8.00%.

CONCLUSION

Analysis of the clinical characteristics indicated that early gastric cancer is more prevalent in males with a history of hypertension, with lesions most commonly occurring in the antral region of the stomach. The pathological types are often high-grade intraepithelial neoplasia and well-differentiated adenocarcinoma, with over 85% of patients having comorbid intestinal metaplasia and atrophy. Despite endoscopic resection, a positive margin rate persisted, indicating a probability of residual cancer at the margins. Postoperative complications, such as gastrointestinal obstruction, incisional infection, gastric perforation, and gastric bleeding can occur and require timely symptomatic treatment.

Keywords: Early gastric cancer; Clinical characteristics; Endoscopic resection; Complications

Core Tip: Understanding the clinical characteristics of patients with early gastric cancer and analyzing the effect of endoscopic resection and the risk of complications can help patients with early gastric cancer prolong their survival.