A micrometric classification of intramucosal carcinomas of the stomach.
BACKGROUND: The aim of this study was to assess whether the results of micrometric measurements could be correlated with the macroscopic-endoscopic classification of intramucosal carcinomas of the stomach.METHODS: The thickness of 86 consecutive intramucosal gastric carcinomas (IMGCs) was micrometrically assessed. IMGCs having more than twice the thickness of the non-involved gastric mucosa (NIGM) were regarded as protruding (type I) and those having twice or less of the thickness of the NNGM, as non-protruding (type II). Non-protruding IMGCs were subclassified as elevated (thicker than NNGM, or type IIa), flat (the same thickness as NNGM, or type IIb), and depressed (thinner than NNGM, or type IIc).RESULTS: Only 9.3% ( n = 8) of the 86 IMGCs were protruding and 90.7% ( n = 78) were non-protruding. Of the 78 non-protruding IMGCs, 46.2% ( n = 36) were elevated (type IIa), 38.5% ( n = 30) were flat (type IIb), and the remaining 15.4% ( n = 12) were depressed (type IIc). A low correlation was found when the micrometric and a similar gross classification were compared. Protruding and elevated IMGCs were often histologically of intestinal type (60.3%), whereas flat and depressed IMGCs were often of diffuse type (73.9%).CONCLUSION: Tumor differentiation may be related to the micrometric profile of the tumor. Non-protruding IMGCs (type II) may expand laterally, without "becoming" protruding and without invading the submucosal layer.
Rubio
Carlos A.
CA
Gastrointestinal and Liver Pathology Research Laboratory, Department of Pathology, Karolinska Institute, 171 76 Stockholm, Sweden.
Nesi
Gabriella
G