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, 11 (6), 807-812

The Characteristics and Prognosis of Diffuse-Type Early Gastric Cancer Diagnosed During Health Check-Ups


The Characteristics and Prognosis of Diffuse-Type Early Gastric Cancer Diagnosed During Health Check-Ups

Ji Young Lee et al. Gut Liver.


Background/aims: Because of the poor prognosis of diffuse-type gastric cancer, early detection is important. We investigated the clinical characteristics and prognosis of diffuse-type early gastric cancer (EGC) diagnosed in subjects during health check-ups.

Methods: Among 121,111 subjects who underwent gastroscopy during a routine health check-up, we identified 282 patients with 286 EGC lesions and reviewed their clinical and tumor-specific parameters.

Results: Patients with diffuse-type EGC were younger, and 48.1% of them were female. Serum anti-Helicobacter pylori IgG (Hp-IgG) was positive in 90.7% of diffuse-type EGC patients (vs 75.9% of intestinal-type EGC, p=0.002), and the proportion of diffuse-type EGC cases increased significantly with increasing Hp-IgG serum titers (p<0.001). Diffuse-type EGC had pale discolorations on the tumor surface (26.4% vs 4.0% in intestinal-type EGC, p<0.001) and were often located in the middle third of the stomach. Submucosal invasion or regional nodal metastasis was observed more commonly in patients with diffuse-type EGC. However, during the median follow-up period of 50 months, 5-year disease-free survival rates did not differ between the groups.

Conclusions: Diffuse-type EGC shows different clinical and endoscopic characteristics. Diffuse-type EGC is more closely associated with Hp-IgG seropositivity and a higher serum titer. Early detection results in excellent prognosis.

Keywords: Diffuse-type; Early diagnosis; Endoscopy; Prognosis; Stomach neoplasms.

Conflict of interest statement


No potential conflict of interest relevant to this article was reported.


Fig. 1
Fig. 1
The proportions of diffuse-type early gastric cancer (EGC) according to serum anti-Helicobacter pylori IgG titers. The proportion of diffuse-type EGC cases increased significantly with serum anti-H. pylori IgG titers (p-value by linear-by-linear association).
Fig. 2
Fig. 2
Kaplan-Meier curves for the 5-year disease-free survival analysis. The 5-year disease-free survival rate was 98.2% in all patients with early gastric cancer (EGC), 97.1% in patients with intestinal-type EGC, and 100% in patients with diffuse-type EGC (p=0.079).

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