J.Jpn. Surg. Soc.. 79(10): 1335-1343, 1978

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Original article

PROGRESSION OF EARLY GASTRIC CARCINOMA TO LYMPHATIC SYSTEM
(With particular reference to relationship between main lesions in gastric wall and metastasis to lymph nodes)

It is said that whether there is the metastasis to the regional lymph nodes or not are closely related the prognosis of gastric cancer, even in the case of early gastric cancer. 367 cases of early gastric carcinoma and 6149 lymph nodes with them were used as materials for study in order to unravel the relationship between metastasis of early gastric carcinoma to the lymph nodes and the findings in the main lesions in the gastric wall.
It was considered that metastasis to lymph nodes would follow the invasion of the submucosal lymphatic ducts. However, discontinuity of this sequence was found in a few cases. In such the cases, the coexistent ulcers seemed to play an important role to raising the carcinoma. In other words, the so-called dynamic change in the malignant cycle in early gastric carcinoma appeared to break down the continuity between ly+ and n+ . The relationship between the findings in the main leasions and metastasis to the lymph nodes in the cases with ly+ greatly differed form that in the cases with ly- . That is, out of the cases with ly- , metastasis to the lymph nodes was more frequent in the cases of excavated type and poorly differentiated lesions and those with coexistent ulcers, while out of the cases with ly+ , the metastsis was more frequent in the cases of elevated and highly differentiated carcinoma and those without coexistent ulcers.

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