Stomach and Intestine(Tokyo) Volume 31, Issue 5 (April 1996)

Significance of Superficially-Spreading Early Gastric Carcinoma in Progression of Undifferentiated Type Gastric Carcinoma Hiroyuki Sugihara 1 , Takanori Hattori 1 1The First Department of Pathology, Shiga University of Medical Science Keyword: 表層拡大型早期胃癌 , DNA ploidy , 未分化型胃癌 , 印環細胞癌 , 癌進展 pp.613-621
Published Date 1996/4/25
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 It was first pointed out by Inokuchi et al. that superficially-spreading and penetrating cancers may reflect a difference of genetic constitution as they correlated to different ploidy patterns. Further studies, however, revealed that such a correlation is seen typically in undifferentiated-type gastric cancers and is obscure in the differentiated-type. In this study, we confined our materials to undifferentiated-type cancer of which the mucosal lesion showed signet-ring cell carcinoma (30 early and 39 advanced cancers) and we attempted to clarify the significance of superficially-spreading early cancers in the overall progression of undifferentiated-type gastric cancers by mapping the cytometrically determined ploidy of metaphase cells in the individual cancers and correlating the ploidy constitution to the stage and the size of the mucosal spread. Our results are as follows; (1) Aneuploidy was detected in one of 30 (3%) early cancers and 27 of 39 (69%) advanced cancers and was almost always accompanied by diploid cancer cells in the mucosa, suggesting that advanced cancers with aneuploidy may be preceded by diploid early cancers. (2) There is some evidence that the incidence of polyploidy reflects the degree of chromosomal instability. In purely diploid areas of advanced cancers, the incidence of polyploidy was 20~30%, being as low as that of diploid early cancers. These areas are suggested to be residual“early”lesions. (3) The incidence of aneuploid foci was constant irrespective of the size of the mucosal spread of the advanced cancers of which the mucosal spreads were 2 cm or more in greatest diameter. Thus, provided that undifferentiated type gastric cancers are monoclonal in origin, aneuploidy may occur in a stochastic process (not only in an incipient stage of cancer growth) and the diversity in growth pattern of stomach cancer can be ascribed to variability in the time when aneuploidy occurs in the tumor. From this point of view, superficially spreading“early”cancer is suspected to be the diploid cancer that remains in an“early”stage for a long time simply because the aneuploid evolution has not yet occurred.

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31巻5号 (1996年4月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院