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The Histological Characteristics of Gastric Cancer in the Young Minako Hirahashi 1 , Yoshinao Oda 1 1Department of Anatomic Pathology, Graduated School of Medical Sciences, Kyushu University, Fukuoka, Japan Keyword: 若年者胃癌 , 30歳未満 , H. pylori感染 , 腸上皮化生 , リンパ濾胞過形成 pp.1308-1315
Published Date 2011/8/25
DOI https://doi.org/10.11477/mf.1403102325
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 First, we compared 65 surgically resected specimens from young patients(below the age of 30 ; young group)and 115 surgically resected specimens of middle-aged or older patients(more than 40 years of age ; not-young group)with gastric cancer, including advanced cases. Moreover, histological findings of non-cancerous specimens around the cancer from the two groups were compared. 18 young cases with intramucosal gastric cancer of poorly-differentiated type and 42 not-young cases with tumors of the identical depth and histological type were observed and the degree of gastritis was compared, including H. pylori infection. The degree of gastritis and H. pylori infection was evaluated according to the updated Sydney system. In the young group, the prevalence among females(69.2% vs. 36.5%, p<0.001)and poorly differentiated adenocarcinoma(84.2% vs. 65.2%, p=0.004)were more frequently seen than in the not-young group. The incidence of H. pylori infection was significantly higher in the young group than in the not-young group(81.5% vs. 20.9%, p<0.001). Within the surrounding non-cancerous mucosa, the density of neutrophilic infiltration was significantly more increased(p=0.028), and the degrees of glandular atrophy and intestinal metaplasia were significantly lower in the young group than in the not-young group(p<0.001). When we compared intramucosal gastric cancer in the young and the not-young patients, the incidence of H. pylori infection was significantly higher in the young group than in the not-young group(94.4% vs. 35.7%, p<0.001), and the density of H. pylori was also higher in the body mucosa in the young group than in the not-young group(p=0.0012). Within the background mucosa, intestinal metaplasia in both body and antral mucosa was less frequent(p<0.01)and antral lymphoid-follicle hyperplasia was more prominent(p=0.005)in the young group than in the not-young group. Glandular atrophy was similar in both groups.

 In conclusion, poorly differentiated adenocarcinoma especially in females without intestinal metaplasia is more frequently seen in young patients with gastric cancer. Furthermore, intramucosal gastric adenocarcinoma of poorly differentiated type in young patients may be associated with H. pylori infection accompanied by antral chronic inflammation with lymphoid-follicle hyperplasia, regardless of the existence of intestinal metaplasia within the background gastric mucosa.


Copyright © 2011, Igaku-Shoin Ltd. All rights reserved.

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

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