Gut and Liver (Sep 2023)

The Clinicopathological Features of Mixed Carcinoma in 7,215 Patients with Gastric Cancer in a Tertiary Hospital in South Korea

  • Hyeong Ho Jo,
  • Nayoung Kim,
  • Hyeon Jeong Oh,
  • Du Hyun Song,
  • Yonghoon Choi,
  • Jaehyung Park,
  • Jongchan Lee,
  • Hyuk Yoon,
  • Cheol Min Shin,
  • Young Soo Park,
  • Dong Ho Lee,
  • Hye Seung Lee,
  • Young Suk Park,
  • Sang-Hoon Ahn,
  • Yun-Suhk Suh,
  • Do Joong Park,
  • Hyung Ho Kim,
  • Ji-Won Kim,
  • Jin Won Kim,
  • Keun-Wook Lee,
  • Won Chang,
  • Ji Hoon Park,
  • Yoon Jin Lee,
  • Kyoung Ho Lee,
  • Young Hoon Kim,
  • Soyeon Ahn

DOI
https://doi.org/10.5009/gnl220254
Journal volume & issue
Vol. 17, no. 5
pp. 731 – 740

Abstract

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Background/Aims: There are few reports regarding mixed carcinoma, defined as a mixture of glandular and poorly cohesive components, in patients with gastric cancer (GC). The aim of this study was to evaluate the proportion and characteristics of mixed carcinoma in GC patients. Methods: A total of 7,215 patients diagnosed with GC at Seoul National University Bundang Hospital were enrolled from March 2011 to February 2020. GC was divided into four groups (well-moderately differentiated GC, poorly differentiated GC, poorly cohesive carcinoma, and mixed carcinoma). The proportion of each GC type and the clinicopathological features were analyzed and divided into early GC and advanced GC. Results: The proportion of mixed carcinoma was 10.9% (n=787). In early GC, submucosal invasion was the most common in poorly differentiated (53.7%), and mixed carcinoma ranked second (41.1%). Mixed carcinoma showed the highest proportion of lymph node metastasis in early GC (23.0%) and advanced GC (78.3%). In advanced GC, the rate of distant metastasis was 3.6% and 3.9% in well-moderately differentiated GC and mixed carcinoma, respectively, lower than that in poorly differentiated GC (6.4%) and poorly cohesive carcinoma (5.7%), without statistical significance. Conclusions: Mixed carcinoma was associated with lymph node metastasis compared to other histological GC subtypes. And it showed relatively common submucosal invasion in early GC, but the rates of venous invasion and distant metastasis were lower in advanced GC. Further research is needed to uncover the mechanism underlying these characteristics of mixed carcinoma (Trial registration number: NCT04973631).

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