Comparison of diagnostic accuracy between linear EUS and miniprobe EUS for submucosal invasion in suspected early gastric cancer

Clinicopathological characteristics of well-differentiated gastric cancer missed by endoscopy

The objective was to explore the clinicopathological features of moderately well-differentiated gastric cancer missed by endoscopy. The clinicopathological data of 88 patients who were diagnosed as moderately well-differentiated gastric cancer by biopsy and pathology from January 2019 to December 2020 in Anyang Tumor Hospital were analyzed retrospectively. The clinicopathological features and immunophenotypic characteristics of these gastric cancers were analyzed together with the literature review. Seventy males and 18 females were included in this study. There were 59 cases of gastritis, 14 cases of ulcer and 15 cases of polyp under endoscope. Based on mucous phenotype, there were 27 gastric cases, 18 intestinal cases, 39 gastrointestinal cases and 4 untyping cases. 54 cases expressed mutant p53 and 34 cases had wild type p53. None of the indicators could yield reliablediagnosis, which requires comprehensive morphological and immunohistochemical analysis by the pathologist. Meanwhile, the clinician should give the patient a systematic treatment plan incuding endoscopy, magnifying endoscopy, NBI, linear endoscopic ultrasound and other examinations. Regardless of the diagnostic criteria, once the pathology suggests a tumor lesion, local resection should be performed first. Additional surgery can be performed if there is submucosal invasion.

Mixed crawling-type gastric adenocarcinoma

Crawling-type gastric carcinoma is a rare variant of early gastric carcinoma. Endoscopically, it is a poorly defined tumor with a flat appearance and histologically, especially in a small biopsy, mimic intestinal metaplasia with reactive atypia. We present a case in which, due to the finding of foci of signet ring cell carcinoma, correct management of the patient was carried out.