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Transfiguration of Early Gastric Cancer: From a stand point of elucidating a natural history of gastric cancer T. Kasugai 1 , Y. Yosii 1 , H. Sugiura 1 , S. Kobayashi 1 1The First Department of Internal Medicine, Aichi Cancer Center Hospital pp.57-69
Published Date 1981/1/25
DOI https://doi.org/10.11477/mf.1403107902
  • Abstract
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 Has a natural history of gastric cancer completely changed over the past decade? To answer this question seven cases of gastric cancer consisting of 5 of depressed type and 2 of elevated type followed up retrospectively and/or prospectively by UGI series, endoscopy and biopsy for at least more than three years and picked up among gastric cancer cases treated at the first department of internal medicine, Aichi Cancer Center Hospital were studied.

 Follow-up periods were from 3 years and 6 months, to 11 years and 3 months. Gastric cancers of depressed type were followed up from 5 years and 2 months to 11 years and 3 months, and all cases of this type elapsed over 5 years, and two of them eventually underwent partial gastrectomy. An early gastric cancer of m and an advanced gastric cancer of pm were demonstrated.

 A case of Ⅱc type early gastric cancer which had been followed up for 11 years and 3 months appeared a depressed type of early gastric cancer over initial 10 years and 1 month. This suggested that the lesion had grown very slowly over a long period of time. On the contrary, a period of transforming from depressed early gastric cancer into Borrmann type Ⅱ of advanced cancer through Ⅱa+Ⅱc and Ⅱa+Ⅱc advanced was only 9 months.

 Biopsy findings had remained low grade malignancy during a period of early gastric cancer over 10 years but showed a rapid progress from well differentiated tubular adenocarcinoma to poorly differentiated adenocarcinoma through moderately differentiated type during a period 9 months after becoming an advanced tumor.

 Four of 5 cases of early gastric cancer of depressed type showed a malignant cycle in their course.

 In one case a Ⅱa+Ⅱc and an atypical epithelium developed on the basis of gastritis for 5 years and 2 months, and another case in which a Ⅱa lesion of early gastric cancer developed an advanced gastric cancer of Borrmann type Ⅲ through Borrmann type Ⅱ for a relatively short period of 3 years and 6 months were also observed.

 No definite difference was observed in the course between cases treated with chemotherapy and/or immunochemotherapy, and cases without chemotherapy. It is concluded that no apparent change was observed in a natural history of early gastric cancer at present.


Copyright © 1981, 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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