J.Jpn. Surg. Soc.. 87(9): 1185-1189, 1986

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Report on the annual meeting

A CLINICOPATHOLOGICAL STUDY OF EARLY GASTRIC CARCINOMA
－WITH REFERENCE TO THESE MACROSCOPIC TYPES IN THE LESION－

Clinicopathological data obtained in 395 cases of early gastric carcinoma (EGC) were reviewed. They composed of 180 intramucosal cases (m) and 215 submucosal cases (sm). Of the 395 cases 92 (23.3%) were of a protruded or an elevated type (P-type). Thus, the depressed type was predominant. Histologically, about 47.6% of well differentiated adenocarcinoma were of P-type and 88.4% of poorly differentiated adenocarcinoma came under the D-type. As a whole, many cases of moderately or poorly differentiated adenocarcinoma fell under the D-type. The incidence of lymphatic metastasis in mucosal and submucosal carcinoma was 1.7% and 22.3%, respectively, and was somewhat higher in IIa + Ilc type cancer. Lymph node metastases were noted in the primary (n₁) or second (n₂) group but was not in the third group. These results suggest that resection of EGC should be coupled with cleaning lymph nodes in first two groups (R₂) as a rule. A postoperative prognosis in our cases was good, but in Ila + Ilc type cancer and in n₂ positive cases, were not so good. From these results, in IIa + Ilc type cancer, R₂ + α operation should be done.
Furthermore, it may be suggested that the analysis of nuclear DNA of early gastric carcinoma is a useful means for judgment of biological behavior.

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