Intestinal-type Adenocarcinoma in the Fundic Gland Area of the Stomach: Its Pathological Features Yasushi Endoh 1 , Hidenobu Waatanabe 1 , Jiroh Hitomi 1 , Ken Nishikura 1 1The First Department of Pathology, Niigata University School of Medicine Keyword: 胃底腺領域 , 分化型腺癌 , p53蛋白発現 , c-erbB-2蛋白発現 pp.1009-1023
Published Date 1994/9/25
DOI https://doi.org/10.11477/mf.1403105906
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 We elucidated the pathological features of intestinaltype (differentiated-type) adenocarcinoma, which was located wholly or partly, in the fundic gland area (FGA) of the stomach by comparing them with those in the antral gland area (AGA). Carcinomas with lymphoid stroma which contain parts of differentiated-type carcinoma were prevalent in FGA (9.5% in FGA, 2.0% in AGA), and many of them included a gastric phenotype in differentiated-type adenocarcinoma-parts (4/6 in FGA). Differentiated-type adenocarcinomas with low-grade atypia which were mimicking complete-type intestinal metaplasia were found in FGA alone (4.8%, 3/63), and this evidence arises us a great interest about the relationship between cancers of this type and complete-type intestinal metaplasia which is a predominant form of intestinal metaplasia in FGA.

 The frequency of cancers invading the submucosa was higher in FGA (FGA: 36.5%, AGA: 2.2%)(p<0.01), even in carcinomas with low-grade atypia.

 Macroscopically, early cancers of 0-Ⅱb type occurred frequently in FGA, and they tended to spread widely on the lesser curvature of the stomach. In advanced cancers, 4-type was prominent and 3-type was infrequent in FGA. As to p 53 and c-erbB-2 protein immunoreactivity, there were no differences in distribution pattern and grading of positive cells between FGA-and AGA-carcinomas.

 The above features of differentiated-type cancers in FGA are considered to derive from its histo-anatomical environment, such as thinness of the muscularis mucosa, richness in capillaries and lymphatic vessels, as well as its mucosal environment.

Copyright © 1994, Igaku-Shoin Ltd. All rights reserved.


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