Journal of Gastroenterology

, Volume 52, Issue 5, pp 594–601 | Cite as

Early gastric cancer with a mixed-type Lauren classification is more aggressive and exhibits greater lymph node metastasis

  • Jeung Hui Pyo
  • Hyuk Lee
  • Byung-Hoon Min
  • Jun Haeng Lee
  • Min Gew Choi
  • Jun Ho LeeEmail author
  • Tae Sung Sohn
  • Jae Moon Bae
  • Kyoung-Mee KimEmail author
  • Seungmin Yeon
  • Sin-Ho Jung
  • Jae J. Kim
  • Sung Kim
Original Article—Alimentary Tract



The clinicopathological features of mixed-type (MT) early gastric cancer (EGC) according to Lauren’s classification remain uninvestigated. This study aimed to clarify the clinicopathological features of MT EGC, particularly in relation to lymph node metastasis (LNM) and long-term survival.


This study included 5309 patients who underwent gastrectomy for EGC. The clinicopathological features, LNM, and long-term outcomes of patients with MT carcinomas were compared with those of patients with intestinal-type (IT) and diffuse-type (DT) cancers. Furthermore, we evaluated the predictors of LNM in each Lauren classification subgroup.


Patients with MT carcinomas were likelier to have larger tumors, submucosal invasion, lymphovascular invasion, and LNM than those with IT or DT carcinomas. Multivariate logistic regression analysis revealed that the Lauren classification was a significant predictor of LNM (P < 0.001). The significant predictors of LNM in MT carcinomas were female sex, greater tumor size, presence of submucosal invasion, and lymphovascular invasion. However, the overall survival of patients with MT carcinoma was not significantly different from that of patients with IT or DT carcinomas (P = 0.104).


The presence of MT EGC carries a higher risk of LNM compared with the presence of IT or DT carcinomas. Therefore, MT carcinomas should be managed with gastrectomy that includes lymph node dissection instead of endoscopic resection.


Lauren’s classification Mixed type Early gastric cancer Lymph node metastasis 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Japanese Society of Gastroenterology 2016

Authors and Affiliations

  • Jeung Hui Pyo
    • 1
  • Hyuk Lee
    • 1
  • Byung-Hoon Min
    • 1
  • Jun Haeng Lee
    • 1
  • Min Gew Choi
    • 2
  • Jun Ho Lee
    • 2
    Email author
  • Tae Sung Sohn
    • 2
  • Jae Moon Bae
    • 2
  • Kyoung-Mee Kim
    • 3
    Email author
  • Seungmin Yeon
    • 4
  • Sin-Ho Jung
    • 4
    • 5
  • Jae J. Kim
    • 1
  • Sung Kim
    • 2
  1. 1.Department of Medicine, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  2. 2.Department of Surgery, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  3. 3.Department of Pathology, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  4. 4.Biostatistics and Clinical Epidemiology Center, Samsung Medical CenterSungkyunkwan University School of MedicineSeoulSouth Korea
  5. 5.Department of Biostatistics and BioinformaticsDuke UniversityDurhamUSA

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