Reactive changes in the esophageal epithelium and predictability of survival for patients with adenocarcinoma of the upper third of the stomach.
In 93 patients with an adenocarcinoma in the upper third of the stomach and involving the lower esophagus, the authors examined the histopathologic changes of the esophageal epithelium at the involved lesion, and the prognosis. Changes in the esophageal epithelium were histologically divided into four groups: hyperplastic (34 cases), atrophic (26 cases), hyperplastic and atrophic (mixed, 20 cases), and no change (13 cases) types. The hyperplastic type was closely related with the expanding mode of invasion and depth of the invasion was less than seen with the atrophic type (P less than 0.05). The rate was significantly higher in cases of a curative resection and the outcome was better than seen with the other types (P less than 0.01-0.001). The atrophic type was related with Borrmann type IV of the gross type and infiltrative mode of invasion, and had a significantly longer length of esophageal invasion than did the hyperplastic and the no change types (P less than 0.01). The prognosis was significantly poorer than seen with the hyperplastic (P less than 0.001) or the mixed types (P less than 0.01). Our study shows that histopathologic changes in the esophageal epithelium provide the surgeon with useful prognostic indicators in cases of an adenocarcinoma in the upper third of the stomach and involving the lower esophagus.
Okamura
T
T
Division of Clinical Pathology, Faculty of Medicine, Kyushu University, Japan.
Korenaga
D
D
Saito
A
A
Baba
H
H
Sugimachi
K
K
D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology*; D001284:Atrophy / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D006965:Hyperplasia / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*