The phenotypic expression of mucin-secreting cell sin 152 surgically resected gastric adenocarcinoma specimens of Korean patients using mucin histochemistry were evaluated by WHO classification, used to determine whether intestinal metaplasia
whose
significance as being precancerous is stressed in the Lauren classification were present alongside with cancer cells in the specimens, and analyzed according to other clinicopathologic parameters. PAS-concanavalin A, galactose oxidase Schiff, and
high
iron disamine-alcian blue staining techniques were employed in identifying mucosubstances in the cytoplasms of the surface mucous cells. the pyloric gland cells, and the goblet cells of small and large intestines.
1) Of the 152 specimens studied, 105(69%) revealed as having mixture of various mucin-se-creting cancer cells, 13(9%) only a single type of mucin-secreting cells, and 34 (22%) no mucinsecreting cells.
2) The surface mucous cell type were shown in 104 cases (68%), the pyloric gland cell type in 85 cases (56%), the large goblet cell type in 81 cases (53%), and the small goblet cell type in 67 cases (44%) in decreasing order of frequency.
3) The poorer the cell differentiation of adenocarcinoma, the more predominant were the number of mucin-secreting cancer cells. Many well-differentiated adenocarcinomas showed no mucin-secreting cells.
Nearly all signet ring cell and mucinous adenocarcinomas showed mixture of mucin-secreting cancer cells.
4) Intestinal metaplasia as precancerous lesion was not significant in the studied specimens. The goblet cell type were expressed in 77 percent of the diffuse type cancers by Lauren classification, and the surface mucous cell type and the
pyloric
gland
cell type in 54 and 49 percent of the intestinal type cancers.
5) The frequency of the mucin-secreting cancer cells did not differ significantly according to patient age, sex, or location and size of the tumor. However, grossly uleerofungationg type more likely carried no mucin-secreting cells than did the
ulceroinfiltrating type.
6) The mixture of mucin-secreting cancer cells were frequently expressed in small tumors and early gastric cancers. The frequency of the surface mucous cell type and the large goblet cell type were lower in the early phase of advanced carcinoma
than
EGC. Lymph node metastasis increased the frequency of finding the pyloric gland cell type.
Mucin histolchemistry appar to provide a better means of characterizing gastric adenocarcinoma than does the conventional method, based on tumor classification by glandular structure. The expression of mucin-secreting cancer cells generally
increases
with poor tumor differentiation and tumor progression but each phenotypic cells may have a different blologic behavior. There seems to be two growth patterns of gastric cancer development. The knowledge of cancer cell types may be an important
clue
for
selecting cases for molecular biologic study.
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