title: [Clinicopathological study on minute- and small-gastric cancer--growing pattern in incipient phase of gastric cancer development and its clinical significance].
abstract: A clinicopathological study was performed on 13 cases of minute gastric cancer (14 lesions) with a diameter less than 5.0 mm and 33 cases of small gastric cancer (34 lesions) with a diameter between 5.1 mm and 10.0 mm. The incidence of flat lesions, multiple cancer and differentiated adenocarcinoma was more frequent in minute and small gastric cancer than in ordinary early gastric cancer with a diameter greater than 11 mm. The incidence of submucosal invasion in single cancer case (30.6%, 11/36) was significantly higher than that in multiple cancer case (8.3%, 1/12). The size of the smallest lesion invading the submucosal layer was 3.2 mm in diameter. Histological examination of the cancer lesions revealed that differentiated adenocarcinoma began to develop at the deeper mucosal layer, while undifferentiated adenocarcinoma did at the superficial mucosal layer. It was also demonstrated that the differentiated adenocarcinoma invaded the submucosal layer through the natural crevices of lamina muscularis mucosa. Pathological and mucohistochemical analysis of both the cancer cells and the surrounding mucosal tissue showed that intestinal metaplasia of the mucosa, especially mucohistochemically incomplete type metaplasia seemed to have close relation with the histogenesis of the differentiated adenocarcinoma.
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D005260:Female; D005753:Gastric Mucosa / Q000473:pathology*; D006801:Humans; D006965:Hyperplasia; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D013274:Stomach Neoplasms / Q000473:pathology*