Japanese

Clinicopathological Features and Histogenesis of Remnant Gastric Cancer Takashi Yao 1 , Daisuke Yoshimura 1 , Masazumi Tsuneyoshi 1 1Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University Keyword: 残胃癌 , 形質発現 , p53 , 逆流性胃炎 , 腸上皮化生 pp.997-1008
Published Date 2004/6/25
DOI https://doi.org/10.11477/mf.1403100520
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 Ninety-four cases of gastric remnant cancer after distal gastrectomy were selected for this study, and their clinicopathological features, phenotypic expression and p53expression were analyzed. The cases were divided into three groups :44cases following surgery for benign disease(Be-Group)and22cases occurring more than10years(Ca/≧10-Group)and within10years(Ca/<10-Group)after the first gastrectomy for malignant disease. In the Ca/<10-Group,Billroth-I procedure for anastomosis was more frequent, intestinal metaplasia in background mucosa was more frequent, but reflux gastritis was less frequent. The features suggest carcinogenesis of the Ca/<10-Group is similar to that of multiple gastric carcinoma. On the other hand,Billroth-II procedure for anastomosis was more frequent, intestinal metaplasia in background mucosa was less frequent, but reflux gastritis was more frequent. In addition, intestinal metaplasia was more frequent in the Ca/≧10-Group than in the Be-Group. The features suggest carcinogenesis of the Be- and Ca/≧10-Groups is associated with reflux gastritis, and that of the Ca/≧10-Group is also associated with intestinal metaplasia. With regard to the phenotype of the carcinoma, incomplete intestinal type was the most frequent in the Ca/<10-Group, but gastric type was the most frequent in the Be-Group. This is considered to be associated with intestinal metaplasia in their background mucosa. p53expression was seen in38% of all the cases, but there was no difference between each group in the incidence of p53expression.

 In conclusion, mechanisms of carcinogenesis of gastric remnant cancer after distal gastrectomy are closely associated with the lesions of the first operation, anastomostic procedure and the interval between the first and second operation. The condition of background mucosa (intestinal metapalsia and reflux gastritis)is considered to be most important for its carcinogenesis.

 1) Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan


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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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