Ichiyoshi Y, Tomoda M, Tomisaki S, Oda S, Ohno S, Maehara Y, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Hepatogastroenterology. 1996 May-Jun;43(9):553-9.
BACKGROUND/AIMS: The natural history of gastric cancer, as to how an early gastric cancer develops into an advanced lesion, is still an open question. In this study, we focused on the gastric cancer invading the muscularis propria, and analyzed the relationship between gross appearance and the biological characteristics of gastric cancer.
One hundred and forty six patients with gastric cancer invading the muscularis propria (pm) were studied with special reference to the macroscopic appearance of the primary tumor; Borrmann type vs. EGC type (advanced gastric cancer simulating early gastric cancer), and to the biologic characteristics such as p53 expression and mitotic activity.
Borrmann type comprised 59.6% (87/146) and EGC type comprised 40.4% (59/146) of the cases. Borrmann type cancer was located more commonly in the antral region (71.3%), tended to grow expansively, and had higher rate of vascular vessel invasion and lymph node metastasis. The type of recurrence varied, and the prognosis was poor in patients with Borrmann type cancer. Incidence of p53 overexpression in Borrmann type cancer was 44.1% (15/34), and significantly higher than 25.8% (8/31) in EGC type cancer. Proliferating activity measured by MIB-1 labeling percentage was also higher in Borrmann type (49.8 +/- 11.6 vs. 38.9 +/- 10.9).
These results suggest that Borrmann type and EGC type pm gastric cancers are distinct in their inherent biological nature, and possibly represent the advanced form of penetrating growth (Pen) type and superficially-spreading growth (Super) type, respectively, of early gastric cancers.
背景/目的：胃癌的自然病史，即早期胃癌如何发展为进展期病变，仍是一个悬而未决的问题。在本研究中，我们聚焦于侵犯固有肌层的胃癌，分析了大体外观与胃癌生物学特性之间的关系。
对146例侵犯固有肌层（pm）的胃癌患者进行研究，特别参考了原发肿瘤的宏观外观；Borrmann型与EGC型（模拟早期胃癌的进展期胃癌），以及p53表达和有丝分裂活性等生物学特性。
Borrmann型占病例的59.6%（87/146），EGC型占40.4%（59/146）。Borrmann型癌更常见于胃窦部（71.3%），倾向于膨胀性生长，血管侵犯和淋巴结转移率较高。复发类型各异，Borrmann型癌患者预后较差。Borrmann型癌中p53过表达的发生率为44.1%（15/34），显著高于EGC型癌中的25.8%（8/31）。通过MIB-1标记百分比测量的增殖活性在Borrmann型中也更高（49.8±11.6对38.9±10.9）。
这些结果表明，Borrmann型和EGC型pm胃癌在其内在生物学性质上有所不同，可能分别代表早期胃癌穿透性生长（Pen）型和浅表扩散性生长（Super）型的进展形式。
