Japanese

Detection of Early Cancers Located in the Fundic Gland Region of the Stomach Tetsuya Makino 1 1Tokyo Metropolitan Cancer Detection Center pp.1003-1010
Published Date 1987/9/25
DOI https://doi.org/10.11477/mf.1403112999
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 Sixty-six lesions (52 cases) of early cancer which arose in the fundic gland region were analyzed regarding histopathological, endoscopical, and radiological characteristics. Fifty-five lesions were clinically detected, with remaining 11 lesions histopathologically.

 Patient population was comprised of 47 females (90%) and 5 males (10%), with the peak prevalence between the ages of 40 and 59, similar to linitis plastica type cancer.

 Gross classification included 29 type-Ⅱc lesions accompanying no ulceration, 31 type-Ⅱc accompanying ulceration (both active and scarring), and 6 type-Ⅱb. All 66 were poorly differentiated cancers.

 As to the relationship between the presence of ulceration and the depth of cancer invasion, mucosal cancers were more frequently found in the cases without ulceration. In contrast, submucosal cancers were more frequently found in the cases ulceration.

 As to the relationship between the size and the depth of cancer invasion, 37% of the lesions smaller than 2 cm in diameter were submucosal cancers (15/41), implying the cancerous invasion to the submucosal layer at earlier stages.

 As to the relationship between the size and presence of ulceration, 41% of the lesions smaller than 2cm in diameter were accompanied by ulceration (17/41), indicative of probable ulcer formation when small.

 Twenty-five percent of the lesions (single) located on the anterior wall were not correctly diagnosed. The same was true for the lesions on the posterior wall. Even the lesions on the posterior wall were overlooked not infrequently.

 There was no definite relationship between the presence of ulceration and eluded cases.

 Twenty-one percent of early cancer cases located in the fundic gland region had multiple cancers. This fact should be of clinical importance.

 The characteristics of those cancers were irregularlyshaped depression radiologically and discoloration endoscopically.

 Linitis plastica type submucosal cancer is generally considered relatively early cancer in which the extend of cancer spread in the submucosal layer is far greater than that in the mucosal layer.

 On the other hand, submucosal cancer accompanied by “no ulceration” is closely associated with the cancerous growth of linitis plastica type or regarded as the precursor of linitis plastica cancer.

 However, such submucosal cancer cases were rarely encoutered in our case series.

 In the light of the status quo of diagnostic obility of early cancers located in the fundic gland region, not a few problems still remain unresolved.


Copyright © 1987, 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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