The Natural History of Gastric Carcinoma Viewed from Prospective or Retrospective Follow-up Studies: in Relation to Histological Type and Growth Patterns Masayoshi Mai 1 , Yutaka Mibayashi 2 , Yoshiharu Okumura 2 , Yutaka Takahashi 1 1Department of Surgery, Cancer Research Institute Hospital, Kanazawa University 2Division of Gastroenterology, Noto General Hospital Keyword: 胃癌の自然史 , 癌組織型 , 発育進展様式 , Borrmann4型胃癌 pp.39-50
Published Date 1992/1/25
DOI https://doi.org/10.11477/mf.1403106675
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 In order to clarify the natural history of gastric carcinoma we made an analysis of prospective or retrospective follow-up cases in 32 gastric carcinoma patients (early: 11cases, advanced: 21cases), including Borrmann 4 type gastric carcinoma in 9 patients. In this paper the relation of cancer histology and growth patterns was mainly discussed and we came to the following conclusions: (1) 11 of 14 cases with differentiated carcinoma (tub1, tub2) showed slow growing patterns and the period from early cancer to advanced cancer was 4 to 6 years. Nevertheless, three cases showing papillary adenocarcinoma tended to progress rapidly within a short period of one or two years. These cases are considered to be high for biological malignancies. (2) Regarding the natural history of 15 undifferentiated adenocarcinoma patients, including one with early gastric cancer, we classified three types; ①slow growing type accompanied by malignant cycle even in advanced ulcerative cancer, ②rapidly growing carcinoma with solid and medullary pattern, very often leading to complications such as liver metastasis, and ③Borrmann 4 type. (3) As for Borrmann 4 type gastric carcinoma in our 9 cases, we pointed out the primary site by endoscopy, and the observation periods were 12-40 months (average 20 months). The focus of our diagnostic approach should be directed to early detection of Ⅱc-like lesions in the fundic gland area.

Copyright © 1992, Igaku-Shoin Ltd. All rights reserved.


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