This study was designed to investigate the distribution of histologic types of gastric carcinoma and to assess the implication of its histologic type as a prognostic factor.
A total of 826 cases of the resected stomach examined at Seoul National University Hospital during the period of 7 years from January 1974 to December 1980 were classified according to Lauren´s method based on the histo-topographical investigations.
The results were summarized as follows:
1) The mean age of gastric carcinoma patient was 51.7 years; 52.8 years in male and 49.4 years in female. Male to female ratio was 2.0: 1.
2) When classified by Lauren´s method, 52.3% (432/836) of total cases were intestinal type carcinoma, 42.7%(347/826) diffuse type and 5.7%(47/826) mixed type.
3) Most(74.5%) of the intestinal type carcinoma and more than half(59.4%) of the diffuse type carcinoma were the cases of males. The incidence of the intestinal type carcinoma was 1.5 times(312:206) higher than the diffuse type carcinoma in males, while the diffuse type was 1.2 times(141:120) higher than the intestinal type in females. The peak incidence was in the age group of 50~59 years in both types, however, the diffuse type occurred more frequently in younger age group than the intestinal one. The mean age of the diffuse type carcinoma was 48.9 years, while that of the intestinal type was 54.1 years.
4) The pathological characteristics of two types are different in many aspects with a statistical significance(p<0.05). The tumor size of the diffuse type was larger than that of the intestinal type, and the former was located more diffusely and comprised a less proportion of Borrmann type Ⅰ and Ⅱ and a larger proportion of Borrmann type Ⅳ than the latter type. The diffuse type showed more frequent metastasis to regional lymph nodes and invaded the gastric wall more deeply than the intestinal type.
5) Intestinal metaplasia in the neighboring mucosa was found in almost all(95.8%) of the intestinal type. but in 62.5% of the diffuse type.
6) The 5-year survival rate of the intestinal type(43.7%) was higher than that of the diffuse type(30.4%) with a statistical significance (p<0. 01), in a series of 337 follow-up cases.
7) Lauren´s histologic type itself affected the postoperative prognosis according to Cox proportional hazard model, with which the intestinal type showed better prognosis than the diffuse type.
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