Unveiling lymph node metastasis in early gastric cancer

作     者：Nari Shin Tae-Yong Jeon Gwang Ha Kim Do Youn Park 

作者机构：Department of PathologyPusan National University Hospital and Pusan National University School of MedicineBusan 602-739South Korea Biomedical Research InstitutePusan National University HospitalBusan 602-739South Korea Departments of SurgeryPusan National University Hospital and Pusan National University School of MedicineBusan 602-739South Korea Departments of GastroenterologyPusan National University Hospital and Pusan National University School of MedicineBusan 602-739South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第18期

页      面：5389-5395页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by A 2-Year Research Grant of Pusan National University 

主　　题：Early gastric cancer Endoscopic submucosal dissection Lymph node metastasis Biomarker Clinicopathologic features 

摘      要：With respect to gastric cancer treatment,improvements in endoscopic techniques and novel therapeutic modalities[such as endoscopic mucosal resection(EMR)and endoscopic submucosal dissection(ESD)]have been ***,EMR/ESD procedures are widely accepted treatment modalities for early gastric cancer(EGC).These procedures are most widely accepted in Asia,including in Korea and *** the present era of endoscopic resection,accurate prediction of lymph node(LN)metastasis is a critical component of selecting suitable patients for EMR/***,indications for EMR/ESD are based on large Japanese datasets,which indicate that there is almost no risk of LN metastasis in the subgroup of EGC ***,there is some controversy among investigators regarding the validity of these ***,there are currently no accurate methods to predict LN metastasis in gastric cancer(for example,radiologic methods or methods based on molecular biomarkers).We recommend the use of a 2-step method for the management of early gastric cancer using endoscopic *** first step is the selection of suitable patients for endoscopic resection,based on endoscopic and histopathologic *** endoscopic resection,additional surgical intervention could be determined on the basis of a comprehensive review of the endoscopic mucosal resection/endoscopic submucosal dissection specimen,including lymphovascular tumor emboli,tumor size,histologic type,and depth of ***,evaluation of clinical application data is essential for validating this ***,gastroenterologists,surgeons,and pathologists should closely collaborate and communicate during these decisionmaking processes.