Studies on Ulcer Cancer “Type-Ⅲ Early Gastric Cancer” H. Yokoyama 1 1Yokoyama Gastrointestinal Hospital pp.191-195
Published Date 1972/2/25
DOI https://doi.org/10.11477/mf.1403109004
  • Abstract
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 The excavated type of early gastric cancer (Type-Ⅲ) has been considered “ulcer cancer” in which cancer development follows preexisting ulceration as described by G. Hauser in 1926. However, recent investigation revealed the “wane and wax” of ulceration of early gastric cancer (malignant cycle-Murakami) during years of observation. The present study was attempted to disclose the nature of type Ⅲ cancer mainly from histopathological viewpoint.

 Of all 601 cases of early gastric cancer resected at our institution during the past 20 years, the Type-Ⅲ cancer was found in 88 cases (15 per cent). They showed cancer development only on the ridge of ulceration, and never in the bottom of excavation. Therefore “the excavated type” is pathologically not an appropriate expression for this group. When viewed from modes of cancer development around ulcers and histological characteristics of ulceration, these cases can be divided into two groups; in 23 out of 88 cases the concept of “malignant cycle” might be applied to the genesis of malignant ulceration, and accordingly a preceding mucosal cancer might have received peptic ulceration to form “Type-Ⅲ”; however, in the remaining 65 cases precedence of chronic peptic ulcer was most plausible for forming malignant alteration, and mucosal changes surrounding an ulcer (accompanying gastritis) seemed to be a possible site of carcinogenesis.

 Clinically it is claimed that the diagnosis of the Type-Ⅲ cancer can only be established by multiple biopsies since these malignant ulcers could not be differenciated from benign ulcers macroscopically.

Copyright © 1972, Igaku-Shoin Ltd. All rights reserved.


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