Causality of Ulcer and Cancer of the Stomach K. Nakamura 1 , H. Sugano 1 , K. Takagi 2 , K. Kumakura 3 1Dept. of Pathology, Cancer Institute 2Dept. of Surgery, Cancer Institute 3Dept. of Internal Med, Cancer Institute pp.145-156
Published Date 1971/2/25
DOI https://doi.org/10.11477/mf.1403111457
  • Abstract
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 Gastric cancer associated with ulcer substantially involves two problems: “ulceration of cancer” and “canceration of ulcer”. Accordingly, the causality of gastric ulcer and cancer has been investigated on the basis of findings that can be interpreted more objectively and free from conventional concepts of it.

 1. Classification of 285 lesions of intramucosal carcinoma according to their size and incidence of accompanying ulcer in cancer nest in each of the divided groups indicate that the rate of concomitant ulcer in cancer nest increases according as the latter becomes larger. It can thus be presumed that the size of surface area in mucosal carcinoma enlarges for the most part in proportion to the time elapsed since the origination of cancer. In addition to this, the fact that of 63 lesions of minute carcinoma under 5mm in the largest diameter only one solitary lesion (1.6 per cent) was associated with ulcer seems to show that the majority of cancer nests accompanied with ulcer should be regarded as not owing to canceration of ulcer, a phenomenon of rare occurrence, but to ulceration of cancer.

 2. Simple diagrammatic representation of topographic relation between ulcer and cancer in intramucosal carcinoma has been attempted to determine incidence of concomitant ulcer (and if possible to find any respective characteristics) in the groups classified according to cancer size. As a result it has been found that the majority of cancer lesions under 2 cm in the largest diameter were of disc-shape, while those over 2.1 cm were predominantly of torusshape. As ahole must be bored into a disc in order to shape a torus, so is an ulceration of cancer presumably requisite for enlargement of cancer lesion.

 3. Of 17 cases of intramucosal carcinoma completely surrounded with fundic gland mucosa, 15 were associated with ulcer. It is only of rare occurrence for an ulcer to originate in the fundic gland area. Nevertheless, the majority of cancer originating there as in the present cases seem to strongly advocate ulceration of cancer.

 Viewed along the linesas listed above, it is assumed that the majority of cancer accompanied with ulcer is due to “ulceration of cancer”.

Copyright © 1971, Igaku-Shoin Ltd. All rights reserved.


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