Wu M S, Yang K C, Shun C T, Hsiao T J, Lin C C, Wang H P, Chuang S M, Lee W J, Lin J T
Department of Internal Medicine, National Taiwan University Hospital, Taipei.
J Clin Gastroenterol. 1997 Dec;25(4):646-9. doi: 10.1097/00004836-199712000-00019.
The clinicopathologic features of 221 patients with intestinal-type (IT) gastric cancer were compared retrospectively with those of 290 diffuse type (DT). Intestinal type was characterized by an older mean age (65.0 +/- 10.8 years vs. 56.2 +/- 13 years), a higher male-female ratio (2.56 vs. 1.06), predominance of blood group O (46.2% vs. 31.1%), and frequent habitual smoking (50.7% vs. 31.4%) and drinking (28.5% vs. 17.6%) than did DT. In contrast, DT had a higher frequency of positive history of parent or sibling with gastric cancer (9.3% vs. 4.1%) and blood group A (40.3% vs. 27.6%) than did IT. The distinguishing histologic features of DT included more Borrmann type IV (13.1% vs. 1.3%) but less Borrmann type I (1% vs. 7.2%), more frequent involvement of middle third (26.9% vs. 15.9%) and whole stomach (4.1% vs. 0%), and more peritoneal seeding (15.5% vs. 9%), lymph node metastasis (67.2% vs. 51%), and nerve permeation (34.1% vs. 24.4%), but less Helicobacter pylori infection (55.9% vs. 69.2%) when compared with those of IT. There was no difference in depth of tumor invasion, venous permeation, duodenal involvement, and postoperative survival between IT and DT. These distinct clinicopathologic features between IT and DT in Taiwan suggest the presence of a different pathogenic process for these two histologic subtypes of gastric cancer.
对221例肠型（IT）胃癌患者和290例弥漫型（DT）胃癌患者的临床病理特征进行回顾性比较。肠型的特征为平均年龄较大（65.0±10.8岁 vs. 56.2±13岁）、男女比例较高（2.56 vs. 1.06）、O血型占比高（46.2% vs. 31.1%），以及经常习惯性吸烟（50.7% vs. 31.4%）和饮酒（28.5% vs. 17.6%），均高于弥漫型。相比之下，弥漫型有胃癌家族史（父母或兄弟姐妹患胃癌）阳性的频率较高（9.3% vs. 4.1%），且A型血占比高（40.3% vs. 27.6%），高于肠型。弥漫型的特征性组织学表现包括Borrmann IV型更多（13.1% vs. 1.3%）但Borrmann I型更少（1% vs. 7.2%），胃中1/3受累更频繁（26.9% vs. 15.9%）和全胃受累更多（4.1% vs. 0%），以及腹膜种植更多（15.5% vs. 9%）、淋巴结转移更多（67.2% vs. 51%）和神经侵犯更多（34.1% vs. 24.4%），但幽门螺杆菌感染更少（55.9% vs. 69.2%），与肠型相比。肠型和弥漫型在肿瘤浸润深度、静脉侵犯、十二指肠受累及术后生存率方面无差异。台湾地区肠型和弥漫型胃癌之间这些明显的临床病理特征提示这两种组织学亚型的胃癌存在不同的致病过程。
