J.Jpn. Surg. Soc.. 83(5): 446-456, 1982

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Original article

STUDIES ON THE MODE OF GROWTH AND SPREAD OF GASTRIC CANCER WITH SPECIAL REFERENCE TO THE CHANGE OF THE HISTOLOGICAL FEATURE

Patho-histological examinations were performed on the surgical materials of 88 cases of early gastric cancer (97 lesions) and 27 cases of “pm gastric cancer”, and 93 autopsy cases with advanced gastric cancer to clarify the mode of the growth and spread of gastric cancer. Histologically 3 types were recognized : differentiated, undifferentiated, and mixed type.
1) Twenty seven out of 97 lesions of early gastric cancer and 10 out of 27 cases of pm cancer showed mixed type.
2) Three out of 38 cases with sm and pm invasion showed histological change from differentiated to undifferentiated type in the invaded lesions, but not vice versa.
3) Autopsy examination revealed distant metastases were frequently found when the primary lesions were differentiated type, whereas in cases of undifferentiated type, peritoneal dissemination was frequently observed. Both patterns were found in cases of mixed type.
4) The change from differentiated to undifferentiated type in metastatic sites was observed more frequently in recurrent cases after gastrectomy than in cases in which gastrectomy was not performed.
5) In cases of differentiated type in primary site, the pulmonary metastases were found in the parenchyma and mostly associated with liver metastases. But in the undifferentiated type, the pulmonary metastases were found in the lymphatic and blood vessels and generally not associated with liver metastases.

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