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

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).

Analysis of Characteristics and Risk Factors of Patients with Single Gastric Cancer and Synchronous Multiple Gastric Cancer among 14,603 Patients

“…Therefore, there was a limitation that p53, EBV, atrophic gastritis, intestinal metaplasia, H. pylori and its eradication treatment which are related with GC, 28 were not performed consistently. 29 , 30 Although the data are not clean in comparison to complete prospective design, we tried to minimize selection bias during the very long period. In addition, 13% of cases lacked pathological dates mainly because surgery could not be performed or surgery was refused, especially in the old age or in the presence of other serious diseases.…”

IFIT1 + neutrophil is a causative factor of immunosuppressive features of poorly cohesive carcinoma (PCC)

“…In addition, a clinical cohort-based single-cell sequencing analysis revealed that poorly differentiated (diffuse) GCs were characterized by significant immunosuppression and a high degree of Epithelial mesenchymal transition (EMT) gene activation [ 12 ]. According to the most recent histological definitions, a significant proportion of examples of diffuse GC are PCC tumors, the latter being further classified as Signet Cell Carcinoma (SRC), Combined, and Not-otherwise-specified (NOS) PCC [ 13 , 14 ]. There are few detailed studies on the molecular or biological mechanisms of PCC.…”