title: Presence of poorly differentiated component correlated with submucosal invasion in the early diffuse-type gastric cancer.
abstract: OBJECTIVE
  Diffuse-type gastric carcinoma is associated with a poor prognosis. However, the clinical behavior of diffuse-type gastric cancer is not fully understood. The aim of this study is to distinguish the behaviors of early diffuse-type gastric carcinomas by sub classifying tumors according to their histologic features.
  
  
  METHODS
  A total of 114 cases of diffuse-type early gastric cancer were studied retrospectively. We analyzed and compared the resected cancer specimens according to the histologic components: as poorly differentiated adenocarcinoma component-present (poor+) versus poorly differentiated adenocarcinoma component-absent (poor-). Helicobacter pylori status was evaluated by Giemsa staining and IgG serology. We assessed the degree of cancer invasion and compared background status of gastritis in accordance with the updated Sydney System criteria and serologic markers.
  
  
  RESULTS
  In comparison to the poor+ cancers, the poor- cancers had a significantly larger portion of cells confined to the mucosa (p=0.002). Only 8 of the 114 cases were regarded as H. pylori-negative. Although we could not detect any serologic markers specific for gastritis with poor+ cancer, but the serum levels of gastrin was slightly higher in patients with poor+ cancers than in those with poor- cancers.
  
  
  CONCLUSIONS
  The biologic behavior of poor+ gastric carcinoma is worse than that of poor- carcinoma. There is a close relation between H. pylori infection and carcinogenesis of poorly differentiated adenocarcinoma.
authors.affiliation: Department of Medicine and Molecular Science, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kuroda
authors.forename: Masanori
authors.initials: M
authors.lastname: Ito
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Wada
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kitadai
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yoshida
authors.forename: Masaharu
authors.initials: M
authors.lastname: Yoshihara
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Sven
authors.initials: S
authors.lastname: Merdh
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000230:Adenocarcinoma / Q000382:microbiology / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005755:Gastrins / Q000097:blood; D005756:Gastritis / Q000097:blood / Q000382:microbiology; D016481:Helicobacter Infections / Q000473:pathology; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D013274:Stomach Neoplasms / Q000382:microbiology / Q000473:pathology*
chemical_list: D005755:Gastrins