Some Considerations of Macroscopic Typing of the Gastric Carcinoma Kyoichi Nakamura 1 1Department of Pathology, The University of Tsukuba, School of Medicine pp.841-850
Published Date 1986/8/25
DOI https://doi.org/10.11477/mf.1403110263
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 According to the rule of macroscopic classification, gastric carcinomas are divided first by infiltrative depth in the gastric wall into two categories, early and advanced. Then, these are further divided into several types. This classification is based on the condition of gastric carcinoma like infiltrative depth, not on the macroscopic findings only. Application of the classification to gastric carcinomas is done in accordance with the law of similarity, independently of the infiltrative depth and size of the carcinomas. For example, Type Ⅰ of the early carcinoma and Borrmann type 1 of the advanced carcinoma are morphologically similar. The same can be said for Type Ⅱc+Ⅱa and Borrmann type 2. Meanwhile, there are cases of the advanced carcinomas macroscopically showing types of the early ones, and vice versa. Based on the aforementioned, it is necessary to rule out the infiltrative depth from the macroscopic classification. Macroscopic configuration of the gastric carcinomas are closely related to the field of cancer-development, histological type and mode of growth. These three factors are related to each other constituting the socalled “triangle for detecting macroscopic types of the gastric carcinomas”. Gastric carcinomas are classified dichotomously for each factor, i.e., fundic gland mucosal area without intestinal metaplasia or the other for the field of cancer-development, undifferentiated (gastric type) or differentiated (intestinal type) for the histological type, and diffuse or circumscribed for the mode of growth. From the view-point of the triangle, the macroscopic typing of the early gastric carcinoma currently done may be practically applied to advanced carcinomas. Further, staging of the primary lesion of the gastric carcinoma has to be described by the three factors, macroscopic type, infiltrative depth and size of the carcinoma so as to determine staging of cancer extension in patients with carcinoma.

Copyright © 1986, Igaku-Shoin Ltd. All rights reserved.


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