Change of mucosal color in early gastric cancer

Objective:: To investigate the association between mucosal color change and the characteristics of early gastric cancer (EGC). Methods:: Data of consecutive patients with EGC resected between August 2005 and October 2010 at Konkuk University Medical Center were analyzed retrospectively. The characteristics of EGC relative to mucosal color change were analyzed. Results:: Whitish discoloration of the cancer was linked to female to male gender ratio (P=0.009), large tumor size (P<0.001), deep invasion (P=0.046) and depressed contours (P<0.001) compared with EGC without discoloration or with hyperemic change. In addition, a whitish discoloration was also related to signet ring cell carcinoma (P<0.001) and diffuse type carcinoma based on Lauren's classification (P<0.001). On multiple linear regression analysis, diffuse type based on Lauren's classification (P=0.017) and depth of invasion (P=0.003) were significant independent factors for whitish discoloration. Conclusions:: Mucosal color change is an important clue in the diagnosis of EGC. EGC with whitish discoloration needs more attention due to its link with the diffuse type of Lauren's classification.