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Development of Ⅱa+Ⅱc Type Early Gastric Cancer Seen During the Follow-up Study of a Protruding Border-Area Lesion (Ⅱa-Subtype), Report of a Case S. Fukuchi 1 1Dept. of Gastroenterology, Toranomon Hospital pp.325-328
Published Date 1975/3/25
DOI https://doi.org/10.11477/mf.1403112231
  • Abstract
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 As the author has shown in No. 2, Vol. 10 of “Stomach and Intestine” under the title of “Gastric Mucosal Change and Sercetory Function as a Background of Elevated Lesion of the Stomach”, the incidence of gastric cancer that accompanies benign polyp of the stomach is relatively low (4%), while Ⅱa-subtype (protruding border-area lesion) is far more often associated with differentiated adenocarcinoma (20%). It has also been demonstrated that benign polyp and Ⅱa-subtype polyp have some different clinical backgrounds in many respects, In benign polyp the male is equally affected as the female, while in Ⅱa-subtype the male far outnumbers the female in frequency, Ⅱa subtype favor s persons stile more advanced in years as compared with benign polyps. Mucosal changes as a background picture of benign polyp consist in various atrophic changes of medium to high degree. Intestinal metaplasia is not necessarily so remarkable, On the other hand, almost all cases of Ⅱa-subtype display not only severe atrophic changes of the mucosa but conspicuous intestinal metaplasia as well. Correspondingly, hypochlorhydria is of higher degree in the latter. It has also been shown that protruding types of gastric carcinoma have clinical backgrounds more akin to Ⅱa-subtype than to benign polyp.

 The case here described shows development of Ⅱa+Ⅱc differentiated adenocarcinoma arising out of the mucosa with severe intestinal metaplasia in the neighborhood of Ⅱa-subtype, which in itself has undergone no remarkable morphological changes both macroscopically and in histologic pictures of biopsy specimens all through the follow-up lasting more than six years.

 The present case is of great interest as showing some relationship between intesinal metaplasia, Ⅱa-subtype and differentiated adenocarcinoma. The nature of Ⅱa-subtype remains unclarified in many respects. Further investigations of such cases are deemed important in the elucidation of relationship common to these lesions.


Copyright © 1975, 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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