Presence of poorly differentiated component correlated with submucosal invasion in the early diffuse-type gastric cancer.
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.
Kuroda
Tsuyoshi
T
Department of Medicine and Molecular Science, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
Ito
Masanori
M
Wada
Yoshihiro
Y
Kitadai
Yasuhiko
Y
Tanaka
Shinji
S
Yoshida
Kazuhiro
K
Yoshihara
Masaharu
M
Haruma
Ken
K
Merdh
Sven
S
Chayama
Kazuaki
K
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*
D005755:Gastrins