위암과 장상피화생의 상관관계에 대한 조직구축학적 조직화학적 연구

Abstract

This study was conducted to investigate morphological relationships between gastric carcinoma and intestinal metaplasia developed in gastric mucosa. One hundred twenty-two cases of gastric cancer resected by gastrectomy were classified by Lauren's methol,i.e. the intestinal type carcinoma and diffuse carcinoma. Author observed that staining quality of goblet cell mucin in metaplastic glands and the frequency of intestinal metaplasia by tumor types. The results obtained were as follows: Intestinal type carcinoma accounted for 65 cases (53.3%); diffuse carcinoma, 40 cases(32.8%); intermediate carcinoma, 12 cases(9.8%); and early carcinoma, 5 cases(4.1%). The mean age of patients with intestinal type carcinoma was 5 years older than the patients with diffuse carcinoma and over 10 years older than the patients with early carcinoma. Grossly the tumors tended to show ulcerative pattern in the intestinal type carcinoma and diffuse infiltrative pattern in diffuse carcinoma. The occurrence of intestinal metaplasia was noted in all cases of early carcinoma, intestinal type carcinoma and intermediate carcinoma except 5 cases of diffuse carcinoma. On mapping intestinal type and intermediate carcinoma had most often combined type of intestinal metaplasia and diffuse carcinoma had small intestinal type. The colonic type was narrow in distribution and closely surrounded to tumor nests. The small intestinal type was diffusely noted in the mucosa in which the tumor cells were infiltrated. Also colonic type metaplasia was commonly found in the proximal portion of stomach while the small intestinal type metaplasia was common in the distal portion. In regard to above results, small intestinal type of intestinal metaplasia may be considered as compensatory responses to infiltration of tumor cells in the gastric wall and it is likely that the development of gastric carcinoma in instestinal metaplasia relate mainly to colonic type.