ADVERTISEMENT
Does the non-lifting sign predict the depth of invasion in early gastric cancer?
Assessment of the invasion depth of early gastric cancer (EGC) is important in deciding between endoscopic and surgical resection treatment methods. The non-lfiting sign (NLS) is widely used for evaluating the invasion depth of EGC, and it is commonly accepted that EMR/ESD is contraindicated for EGC with a NLS because of the probability of massive submucosal invasion. This study was to investigate the NLS as a tool for determining the depth of invasion in EGC.
Eleven patients with EGC who had failed EMR/ESD due to NLS were analyzed in comparison with 68 patients with EGC treated by surgery after EMR/ESD due to submucosal invasion. Factors capable of predicting NLS were searched for in the endoscopic reports, still photographs, and histopathological findings.
The mean size of the 11 lesions with NLS was 2.70±1.14 cm. Six lesions (54.5%) were found in the angle and six lesions (54.5%) were elevated type. The patients with NLS had larger size and more lesions located in the angle than those without NLS. Of 11 patients with NLS, submucosal invasion (sm1) was found in 2 patients, submucosal fibrosis in 5 patients, and submucosal narrowing in 2 patients. However, there was no significant difference between two groups in the age, sex, prior biopsy history, tumor shape, histopathology, lymphatic invasion, and Lauren’s classification.
These results suggest that NLS does not reliably predict deeper cancerous invasion and that the size and location of the lesion may be important factors for NLS.
The authors.
Has not received any funding.
B. Min: Disclosures not submitted. J. Kim: Disclosures not submitted. The other author has declared no conflicts of interest.
