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Xing Y, Wang F, Li J, Qiao Z. Sustained silence of a small signet ring cell carcinoma. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2024; 116:278-279. [PMID: 37706455 DOI: 10.17235/reed.2023.9891/2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
A 47-year-old man developed recurrent bloating. First gastroscopy showed there was a fading lesion about 0.5cm in size near the anterior wall of the large curve of the junction of the gastric antrum and the edge was red, and the biopsy pathology showed signet ring cell carcinoma (SRC). Subsequently, he went to other hospital for endoscopic submucosal dissection (ESD). However, postoperative pathology indicated inflammation. After 6 months, gastroscopy showed that the lesion size was similar to that of the first time, the fading was obvious, and no redness was observed. Another year later, the lesion size was not significantly changed from these before. Weak amplification of Narrow Band Imaging (NBI) showed slight dilatation of the glandular duct, mainly fading, no redness, and the biopsy was still SRC. Finally, he received a second ESD, and the postoperative pathology was consistent with that of our results.
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Affiliation(s)
| | - Fang Wang
- Gastroenterology, Gaochun People's Hospital
| | - Jingya Li
- Yuexi Health Center of Wuzhong District
| | - Zhenguo Qiao
- Gastroenterology, Suzhou Ninth People's Hospital. Suzhou Ninth Hospital Affiliated to Soochow University, China
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Tang YH, Ren LL, Mao T. Update on diagnosis and treatment of early signet-ring cell gastric carcinoma: A literature review. World J Gastrointest Endosc 2023; 15:240-247. [PMID: 37138936 PMCID: PMC10150283 DOI: 10.4253/wjge.v15.i4.240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/02/2023] [Accepted: 03/30/2023] [Indexed: 04/14/2023] Open
Abstract
Gastric signet-ring cell gastric carcinoma (GSRC) is an unfavorable subtype of gastric cancer (GC) that presents with greater invasiveness and poorer prognosis in advanced stage than other types of GC. However, GSRC in early stage is often considered an indicator of less lymph node metastasis and more satisfying clinical outcome compared to poorly differentiated GC. Therefore, the detection and diagnosis of GSRC at early stage undoubtedly play a crucial role in the management of GSRC patients. In recent years, technological advancement in endoscopy including narrow-band imaging and magnifying endoscopy has significantly improved the accuracy and sensitivity of the diagnosis under endoscopy for GSRC patients. Researches have confirmed that early stage GSRC that meets the expanded criteria of endoscopic resection showed comparable outcomes to surgery after receiving endoscopic submucosal dissection (ESD), indicating that ESD could be considered standard treatment for GSRC after thorough selection and evaluation. This article summarizes the current knowledge and updates pertaining to the endoscopic diagnosis and treatment of early stage signet-ring cell gastric carcinoma.
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Affiliation(s)
- Yun-He Tang
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Lin-Lin Ren
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Tao Mao
- Department of Gastroenterology, Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong Province, China
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Utilization of Ultrasonic Image Characteristics Combined with Endoscopic Detection on the Basis of Artificial Intelligence Algorithm in Diagnosis of Early Upper Gastrointestinal Cancer. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:2773022. [PMID: 34880973 PMCID: PMC8648460 DOI: 10.1155/2021/2773022] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 12/26/2022]
Abstract
The aim of this study was to evaluate the diagnostic value of artificial intelligence algorithm combined with ultrasound endoscopy in early esophageal cancer and precancerous lesions by comparing the examination of conventional endoscopy and artificial intelligence algorithm combined with ultrasound endoscopy, and by comparing the real-time diagnosis of endoscopy and the ultrasonic image characteristics of artificial intelligence algorithm combined with endoscopic detection and pathological results. 120 cases were selected. According to the inclusion and exclusion criteria, 80 patients who met the criteria were selected and randomly divided into two groups: endoscopic examination combined with ultrasound imaging based on intelligent algorithm processing (cascade region-convolutional neural network (Cascade RCNN) model algorithm group) and simple use of endoscopy group (control group). This study shows that the ultrasonic image of artificial intelligence algorithm is effective, and the detection performance is better than that of endoscopic detection. The results are close to the gold standard of doctor recognition, and the detection time is greatly shortened, and the recognition time is shortened by 71 frames per second. Compared with the traditional convolutional neural network (CNN) algorithm, the accuracy and recall of image analysis and segmentation using feature pyramid network are increased. The detection rates of CNN model, Cascade RCNN model, and endoscopic detection alone in early esophageal cancer and precancerous lesions are 56.3% (45/80), 88.8% (71/80), and 44.1% (35/80), respectively. The detection rate of Cascade RCNN model and CNN model was higher than that of endoscopy alone, and the difference was statistically significant (P < 0.05). The sensitivity, specificity, positive predictive value, and negative predictive value of Cascade RCNN model were higher than those of CNN model, which was close to the gold standard for physician identification. This provided a reference basis for endoscopic ultrasound identification of early upper gastrointestinal cancer or other gastrointestinal cancers.
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Yeo MK, Kang SH, Eun HS, Lee ES, Moon HS, Kim SH, Sung JK, Lee BS, Jeong HY, Bae GE. Subepithelial spread of early gastric cancer is common and extends more than expected. Gastric Cancer 2021; 24:888-896. [PMID: 33620603 DOI: 10.1007/s10120-021-01171-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/12/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUNDS The clinical significance of subepithelial (SE) spread from early gastric cancer (EGC) is poorly understood. Thus, we evaluated the proportion and extent of SE spread from EGC, as well as related risk factors. METHODS We reviewed medical records and pathological specimens from patients with EGC who underwent surgery or endoscopic resection between January 2016 and December 2016 at Chungnam National University Hospital. RESULTS A total of 404 patients were reviewed and SE spread was identified for 142 patients (35.1%). The presence of SE spread was associated with gender, histological type, location, endoscopic appearance, color change, presence of lymphovascular invasion, and invasion depth. Multivariable analysis revealed that SE spread was only independently associated with histological type. The distance of SE spread was significantly different between histological types, and the maximum distance was 17 mm. CONCLUSION More than 30% of our patients with EGC had SE spread, which could reach up to 17 mm. Given the proportion of SE spread in these cases, a wider resection margin may be safe during endoscopic resection or surgery.
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Affiliation(s)
- Min Kyung Yeo
- Department of Pathology, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Sun Hyung Kang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea.
| | - Hyuk Soo Eun
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Eaum Seok Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Hee Seok Moon
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Seok Hyun Kim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Jae Kyu Sung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Byung Seok Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Hyun Yong Jeong
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Chungnam National University, 282 Munhwa-ro Jung-Gu, Daejeon, 35015, Republic of Korea
| | - Go Eun Bae
- Department of Pathology, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
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Díaz Del Arco C, Ortega Medina L, Estrada Muñoz L, García Gómez de Las Heras S, Fernández Aceñero MJ. Is there still a place for conventional histopathology in the age of molecular medicine? Laurén classification, inflammatory infiltration and other current topics in gastric cancer diagnosis and prognosis. Histol Histopathol 2021; 36:587-613. [PMID: 33565601 DOI: 10.14670/hh-18-309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Gastric cancer (GC) is the fifth most common cancer and the third cause of cancer-related deaths worldwide. In western countries, more than half of GC patients are diagnosed at advanced stages and 5-year survival rates range between 20-30%. The only curative treatment is surgery, and despite recent advances in oncological therapies, GC prognosis is still poor. The main prognostic tool for patient categorization and treatment selection is the TNM classification, but its limitations are being increasingly recognized. Early recurrences may occur in early-stage disease, and patients at the same stage show heterogeneous outcomes. Thus, there is a need to improve GC stratification and to identify new prognostic factors, which may allow us to select drug-susceptible populations, refine patient grouping for clinical trials and discover new therapeutic targets. Molecular classifications have been developed, but they have not been translated to the clinical practice. On the other hand, histological assessment is cheap and widely available, and it is still a mainstay in the era of molecular medicine. Furthermore, histological features are acquiring new roles as reflectors of the genotype-phenotype correlation, and their potential impact on patient management is currently being analyzed. The aim of this literature review is to provide a modern overview of the histological assessment of GC. In this study, we discuss recent topics on the histological diagnosis of GC, focusing on the current role of Laurén classification and the potential value of new histological features in GC, such as inflammatory infiltration and tumor budding.
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Affiliation(s)
- Cristina Díaz Del Arco
- Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain. .,Complutense University of Madrid, Madrid, Spain
| | - Luis Ortega Medina
- Complutense University of Madrid, Madrid, Spain.,Department of Surgical Pathology, Hospital Clínico San Carlos, Madrid, Spain
| | | | | | - Mª Jesús Fernández Aceñero
- Complutense University of Madrid, Madrid, Spain.,Department of Surgical Pathology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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