Abstract
To clarify the risk factors for Iymph node metastasis of submucosal invasive gastric cancertreated by endoscopic mucosal resection(EMR), we investigated the histopathologic findings of 194 surgically resected suhmucosal cancers. As for the histologic types, vve reclassified thesecancers according to the dominant histologic types within the mucosa. In the result, logistic regression analysis showed that the covariants which could predict lymph nods metastasis were 1)papillary adenocarcinoma, 2)histologic heterogeneity in the submucosa, 3)lymphatic invasion. There were no lymph node metastasis and no above-mentioned risk factory in lesions of differentiated subrnucosal cancers(tubl or tub2)measuring 40mm or less in size with less than500μm invasion and measuring 20mm or less in size with less than 1000μm invasion. Furthermore, tubl or tub2 lesions with INFα showed lower lymph node metastasis significantly, suggesting that these risk factors would be useful for decision of EMR indication in borderlinelesions. And we considered that to diagnose submucosal histological findings precisely, anenblock resection method should be performed.
