Kabashima Akira, Yao Takashi, Maehara Yoshihiko, Tsuneyoshi Masazumi
Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Gastric Cancer. 2005;8(4):220-7. doi: 10.1007/s10120-005-0340-9.
It has been proved that some differentiated-type gastric carcinomas have a gastric phenotype. Similarly, it can be conjectured that some undifferentiated-type gastric carcinomas have an intestinal phenotype and that there are biological differences between undifferentiated-type gastric carcinomas with a gastric phenotype and those with an intestinal phenotype. We classified the phenotypes of early undifferentiated-type gastric carcinomas and investigated the relationship between their biological behavior and the phenotypes.
Sixty lesions of intramucosal undifferentiated-type gastric carcinoma were classified into four phenotypes; gastric type, incomplete-intestinal type, complete-intestinal type, and unclassified type, according to the expression of CD10, MUC2, small-intestinal mucinous antigen (SIMA), human gastric mucin (HGM), or concanavalin A (ConA).
The incidence of gastric-type carcinoma, incomplete-intestinal-type carcinoma, and complete-intestinal-type carcinoma was 33% (20 cases), 65% (39 cases), and 2% (1 case), respectively. There was no significant difference in any of the clinicopathological factors examined between the 20 gastric-type carcinomas and the 40 intestinal-type carcinomas, but there were significant differences in the morphological findings. Intestinal-type carcinomas had a glandular structure more frequently than the gastric-type carcinomas. The spreading pattern of gastric-type carcinomas showed a middle-layer type more frequently than the intestinal-type carcinomas.
Undifferentiated-type gastric carcinomas frequently expressed an intestinal phenotype. There were differences in the growth patterns between undifferentiated-type gastric carcinomas with a gastric phenotype and those with the intestinal phenotype.
已证实一些分化型胃癌具有胃表型。同样，可以推测一些未分化型胃癌具有肠表型，并且具有胃表型的未分化型胃癌与具有肠表型的未分化型胃癌之间存在生物学差异。我们对早期未分化型胃癌的表型进行了分类，并研究了它们的生物学行为与表型之间的关系。
根据CD10、MUC2、小肠黏液抗原（SIMA）、人胃黏蛋白（HGM）或伴刀豆球蛋白A（ConA）的表达，将60例黏膜内未分化型胃癌病变分为四种表型：胃型、不完全肠型、完全肠型和未分类型。
胃型癌、不完全肠型癌和完全肠型癌的发生率分别为33%（20例）、65%（39例）和2%（1例）。在20例胃型癌和40例肠型癌之间，所检查的任何临床病理因素均无显著差异，但在形态学表现上存在显著差异。肠型癌比胃型癌更频繁地具有腺管结构。胃型癌的扩散模式比肠型癌更频繁地表现为中层型。
未分化型胃癌经常表达肠表型。具有胃表型的未分化型胃癌与具有肠表型的未分化型胃癌在生长模式上存在差异。
