J.Jpn. Surg. Soc.. 60(5): 810-839, 1959

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HISTOLOGICAL AND STATISTICAL STUDIES ON THE CRITERIA UPON GASTRIC ULCERO-CANCER

Histo-pathological research was done upon the 925 stomach specimen and the 20 cases of chronic round ulcer. The specimens were taken in the 2nd Surgical Department of Tokyo University. After setting up of the criteria and statistical studt upon the ulcero- cancer, obtained results were as follows :
1) Hauser's criteria for the ulcero-cancer is fit for its beginning stage, but not convenient for the developed one.
2) Twenty cases of chronic ulcers were examined according to the 7 histological features of chronic ulcer, such as a) interruption of muscle coat, b) existence of scar, c) fusion of both muscle layers, d) existence of neuroma, e) of foreign body, f) endarteritis obliterance, and g) regeneration of the mucosal glands at the edge of the ulcer.
3) Some of those histological features of chronic ulcer must be also found in ulcero-cancer.
4) Two new specific features were found in ulcero-cancer, should be useful as specific features for deciding cancery, such as ;
i) The growth of cancer from the regenerating epithelia and glands at the edge of the ulcer.
ii) The inclination of cancer infiltration at the right angle to the end of muscle interruption in the bottom of the ulcer.
5) According to the above eight features were decided, as the criteria upon the ulcero-cancer, but the existence of endarteritis obliterans was not reliable for dicision of it.
6) Ulcero-cancer must have one basic histological feature (interruption of muscle coat) and more than two of the supplimental features . Supplimental features mean other six conditions than the interruption of muscle coat and endarteritis obliterans.
7) By using these histological criteria, the frequency of ulcerocancer was calculat d as 24.6% in all stomach cancer.
8) In Japan, the frequency of formation upon chronic ulcer is presumed about five times as many as that of common stomach. Th author holds this opinion for the first time in Japan.
9) It was supposed that more than 20% of chronic ulcers alter into cancers.
10) There is a gastric cancer happened from the scar of ulcer. This is important for the explanation of origin of cancer.
11) The surgical treatment of gastric ulcer is important not only for the treatmenl of itself, but also for the prevention of stomach cancer.
(author' abstract)

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