1994 Volume 44 Pages 82-86
We investigated early gastric cancer according to the relationship between sex, age, depth, tumor size, location, macroscopic type of cancer, histological type of cancer and lymph node metastasis. One thousand and 137 patients (1,291 focuses) of early gastric cancer were analysed retrospectively.
The lymph node metastatic rate was 7.1% among the total early gastric cancer. Metasatatic rate of the single focus of gastric cancer was 7.6%. Especially male, young (20・30's) and elderly ages (70・80's) showed a high rate. Among the single submucosal cancer, 14.9% were metastatized to the lymph node, significantly higher than that of mucosal cancer rate (2.5%) (P<0.05) .
According to the tumor size, the lymph node metastasis were negative in cases of mucosal cancer less than 2.0cm and submucosal cancer less than 0.5cm. Macroscopically, combined type of mucosal cancer and elevated type of submucosal cancer showed high lymph node metastatic rate than the other type. Histologically, mucinous adenocarcinoma showed the highest rate of metastasis, and papillary adenocarcinoma did second. 7.3% and 8.1% metastasis were seen in differenciated and undifferenciated type of early gastric cancer respectively.
Multifocal gastric cancer showed 3.1% lymph node metastasis. In particular female and middle ages (40・50・60's) showed a high rate metastasis. Concerning to the depth of cancer, no metastasis were seen in the mucosal cancer, and 6.2% in submucosal cancer. With respect to the tumor size, 13.0% were positive over 4.1cm, while 0.9% in less than 4.0cm tumor size.
In conclusion ; early gastric cancer without lymph node metastasis were follows ; histologically differenciated type of mucosal cancer, macroscopically without ulcer, and tumor size less than 3.0cm. And futher IIb type of mucosal cancer in any size have showen no metastasis. From the point of view of lymph node metastasis, we consider these early gastric cancer are the indication of endoscopic mucosal resection.
