Goseki N, Takizawa T, Koike M
First Department of Surgery, School of Medicine, Tokyo Medical and Dental University, Japan.
Gut. 1992 May;33(5):606-12. doi: 10.1136/gut.33.5.606.
By combining two of the morphological characteristics of gastric cancer, the degree of differentiation of the glandular tubules and the amount of mucus in the cytoplasm, the histological type of the gastric carcinoma was categorised into four groups. Group I: tubular differentiation--well; mucus in cytoplasm--poor; group II: tubular differentiation--well; mucus in cytoplasm--rich; group III: tubular differentiation--poor; mucus in cytoplasm--poor; group IV: tubular differentiation--poor; mucus in cytoplasm--rich. A study of the relation between the types of primary lesion and the mode of extension and recurrence of gastric carcinoma in 200 autopsy cases was then undertaken. In group I, the frequency and extent of haematogenous metastasis such as in the liver was high, while in group IV, that of lymph node metastasis, direct invasion into surrounding organ, and peritoneal dissemination were higher. In group III, which showed the intermediate mode of extension in nature to those of group I and IV, although the frequency and severity of the bone marrow metastasis was the highest. There were significant differences in the modes of development and the extent of infiltration in all groups.
通过结合胃癌的两个形态学特征，即腺管的分化程度和细胞质中的黏液量，将胃癌的组织学类型分为四组。第一组：腺管分化良好；细胞质中黏液少；第二组：腺管分化良好；细胞质中黏液丰富；第三组：腺管分化差；细胞质中黏液少；第四组：腺管分化差；细胞质中黏液丰富。随后对200例尸检病例的原发性病变类型与胃癌的扩散和复发方式之间的关系进行了研究。在第一组中，血行转移如肝转移的频率和范围较高，而在第四组中，淋巴结转移、直接侵犯周围器官和腹膜播散的频率较高。第三组在本质上显示出介于第一组和第四组之间的中间扩散方式，尽管骨髓转移的频率和严重程度最高。所有组在发展方式和浸润范围上存在显著差异。
