Tsuji Toshiaki, Iwahashi Makoto, Nakamori Mikihito, Ueda Kentaro, Ishida Koichiro, Naka Teiji, Ojima Toshiyasu, Akamatsu Hiroko, Yamaue Hiroki
Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama 641-8510, Japan.
Hepatogastroenterology. 2008 May-Jun;55(84):1150-2.
We report a case of multiple early gastric cancer showing varied histological types associated with gastritis cystica profunda (GCP). A 61-year-old man who had early gastric cancer associated with GCP underwent a distal gastrectomy with lymphadenectomy. Histological examination showed various histological types of cancer -well differentiated, moderately differentiated, poorly differentiated adenocarcinoma, mucinous adenocarcinoma and signet ring cell carcinoma- that had developed independently in the mucosal and submucosal layers of the resected specimen. Furthermore, multiple cysts with a single layer of columnar epithelium were present in the submucosa around the cancerous lesions. However, no neoplastic changes were found in those epithelial cells. Helicobacter pylori was detected in the residual stomach 3 months after surgery. Although the mechanism of the relationship between gastric carcinoma and GCPs is obscure, we speculate that repeated erosion and regeneration induced by chronic inflammation causes multicentric carcinogenesis as well as an aberration of the gastric glands. GCPs may be a risk factor for multiple gastric cancer.
我们报告一例伴有深在性囊性胃炎（GCP）的多种早期组织学类型的早期胃癌病例。一名患有与GCP相关的早期胃癌的61岁男性接受了远端胃切除术及淋巴结清扫术。组织学检查显示，切除标本的黏膜层和黏膜下层出现了多种组织学类型的癌症，即高分化、中分化、低分化腺癌、黏液腺癌和印戒细胞癌，这些癌症是独立发生的。此外，癌灶周围的黏膜下层存在多个单层柱状上皮囊肿。然而，这些上皮细胞未发现肿瘤性改变。术后3个月在残胃中检测到幽门螺杆菌。虽然胃癌与GCP之间关系的机制尚不清楚，但我们推测慢性炎症引起的反复糜烂和再生会导致多中心癌变以及胃腺异常。GCP可能是多发性胃癌的一个危险因素。
