Gut Liver.  2023 Sep;17(5):731-740. 10.5009/gnl220254.

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

• Jo HH
• Kim N
• Oh HJ
• Song DH
• Choi Y
• Park J
• Lee J
• Yoon H
• Shin CM
• Park YS
• Lee DH
• Lee HS
• Park YS
• Ahn SH
• Suh YS
• Park DJ
• Kim HH
• Kim JW
• Kim JW
• Lee KW
• Chang W
• Park JH
• Lee YJ
• Lee KH
• Kim YH
• Ahn S

• KMID: 2546015
• DOI: http://doi.org/10.5009/gnl220254

Abstract

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 (wellmoderately 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).

Keyword

Stomach neoplasms; Pathology; Neoplasm staging; Lymphatic metastasis