Sowa M, Kato Y, Kubo T, Nakanishi K, Nishimura M, Chung Y S, Umeyama K
First Department of Surgery, Osaka City University, Medical School, Japan.
Nihon Geka Gakkai Zasshi. 1991 Nov;92(11):1577-82.
Early gastric cancer in the region of the fundic gland was found to occur predominantly in women. Many lesions of this type were identified in the posterior wall of the middle portion of the stomach. Histologically, the lesions were classified as poorly differentiated carcinomas in all cases of early cancer. In 9 patients with cancer of linitis plastica type having IIc lesions located in the region of the fundic gland, the tumor focus was also in posterior wall of the middle portion of the stomach. Giant folds were present diffusely in all other portions of the gastric mucosa in these latter cases. These cases also had diffuse infiltration of cancer cells into the submucosa, muscle layer and extraserosal regions. Histologically, the lesions were classified in all cases of linitis plastica type as poorly differentiated carcinomas including signet ring cells. Acid mucopolysaccharides (AMPS) and sialic acid were histochemically detected in the interstitial tissues of early gastric carcinomas and linitis plastica type gastric cancers. The AMPS digestion rates were higher for early cancer tissue. The present results support the hypothesis that early gastric cancer in the region of the fundic gland may occur in conditions favoring tumor growth and may develop into cancer of linitis plastica type.
发现胃底腺区域的早期胃癌主要发生在女性中。这种类型的许多病变在胃中部的后壁被发现。组织学上,在所有早期癌症病例中,病变均被分类为低分化癌。在9例胃底腺区域有IIc病变的皮革胃型癌症患者中,肿瘤病灶也位于胃中部的后壁。在这些病例中,胃黏膜的所有其他部分均弥漫性出现巨大皱襞。这些病例还伴有癌细胞向黏膜下层、肌层和浆膜外区域的弥漫性浸润。组织学上,在所有皮革胃型病例中,病变均被分类为包括印戒细胞的低分化癌。在早期胃癌和皮革胃型胃癌的间质组织中,通过组织化学检测到酸性粘多糖(AMPS)和唾液酸。早期癌组织的AMPS消化率更高。目前的结果支持这样的假说,即胃底腺区域的早期胃癌可能在有利于肿瘤生长的条件下发生,并可能发展为皮革胃型癌症。