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KMID : 0378019880310040043
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New Medical Journal
1988 Volume.31 No. 4 p.43 ~ p.48
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STUDY ON THE STROMAL FIBROSIS OF EARLY GASTRIC CANCER, ESPECIALLY THE RELATIONSHIP BEWEEN ULCER AND CANCER
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Suk Dongsoo
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Abstract
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Total 354 early gastric cancers (EGC) of the Japanese National Cancer Center, Tokyo, were analyzed according to the degree of fibrosis of stomach wall under the mostly mucosal EGC, thus six types (A-F) were classified. Twenty-four percent of EGC had no increased fibrosis of submucosa suggesting the earliest EGC, an&60.7% were composed of differentiated-cancer (type A). Another 24%v of EGC´ showed fibrous proliferation of submucosa and this type was composed of 44.2% differentiated cancer (type B). Above findings were speculated that these two types were in the same series of evolutionary process through repeated cancer-ulcer cycle (48% of all EGC). From type C, D and E, there is no correlation from the above view points, thus presuming that these three types were developed independently in the mucosa adjacent to the fibrosis (or ulcer) of the stomach wall (28.8% of all EGC). However, morphologically typical ulcer-cancer was found in 11% (type E). Twenty-three percent had developed from polypoid or elevated lesions of mucosa (type F) with 95% of the cases being composed of well or moderately differentiated cancer. This indicates that the polypoid EGC develop along a completely different pathogenesis from rest of the EGC. Incidence of ulcer increased in a paralled fashion with the degree of fibrosis (6% in type A to 76.9% in type E) indicating a synergistic role or forming a vicious circle of these two lesions.
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