Microvascular architecture of early gastric carcinoma. Microvascular-histopathologic correlates.
BACKGROUND
Gastric carcinoma is clinicopathologically divided into differentiated and undifferentiated types. The former is grossly protuberant and often causes hematogenous metastasis to the liver or lung, whereas the latter is mostly depressed or ulcerated from its early stage and rarely causes blood-borne metastasis. The purpose of this study is to clarify the microvascular architecture of early gastric carcinoma with reference to the histologic subtypes.


METHODS
A silicone rubber compound (Microfil) injection method with a methyl salicylate clearing technique was used in 32 resected early gastric carcinomas. The microvascular architecture was observed both in the carcinoma and its surrounding noncancerous tissue in each specimen under a stereomicroscope and light microscope.


RESULTS
Compared to the surrounding normal mucosa, the differentiated carcinomas (DC) mostly were hypervascular (24%) or normovascular (65%), whereas the undifferentiated carcinomas (UC) often were hypovascular (60%). Irregularity of tumor vessels (67%) and an arcade-like appearance (33%) was encountered frequently in UC, whereas hypervascularity of the surrounding noncancerous mucosa (29%) often was noticed in DC. Quantitative analysis, including vascular volume, mean vascular diameter, and cut section area, supported these differences between DC and UC.


CONCLUSIONS
The results suggest that vascular structures of gastric carcinomas are characteristic with regard to their histologic subtypes; DC is normovascular or hypervascular, whereas UC is hypovascular.
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Y
Y
Adachi
M
M
Mori
M
M
Enjoji
K
K
Sugimachi
D002277:Carcinoma / Q000098:blood supply* / Q000473:pathology; D005753:Gastric Mucosa / Q000098:blood supply / Q000473:pathology; D006801:Humans; D008833:Microcirculation; D013274:Stomach Neoplasms / Q000098:blood supply* / Q000473:pathology