Clinicopathological Study and DNA Ploidy Pattern as a Prognostic Factor in Gastric Cancer with Subserosal Invasion

Masatsugu Kitamura, Kuniyoshi Arai, Kaoru Miyashita

Department of Surgery, Tokyo Metropolitan Komagome Hospital

Four hundred and fifty gastric cancer patients with subserosal invasion (ss-gastric cancer) were subdivided into the groups ssα, ssβ, and ssγ, based on the criteria of the general rules for the gastric cancer study of Japan. The relationship between types of subserosal infiltration and prognosis and clinicopathological characteristics were analyzed. DNA ploidy patterns and their prognoses were also evaluated. In terms of age, the proportion of ssγ gastric cancer was high in the younger generation. A change from localized type to infiltrative type was observed as ss-gastric cancer advanced macroscopically from ssα to ssγ. The rate of liver metastasis in the ssα and ssβ groups was higher than in the ssγ group. Concerning the histological type, ssα and ssβ cases showed the differentiated type more frequently and in ssγ cases the undifferentiated type was more frequent (p<0.01). Extent of lymphatic invasion was greatest in the ssγ group and that of venous invasion was highest in the ssα and ssβ groups. The relationship between type of subserosal infiltration (ssα, ssβ, ssγ) and prognosis was evaluated in patients who underwent curative resection in ss-gastric cancer. Comparison of the outcome in the groups with and without lymph node metastasis showed no significant difference in survival rate between the groups. Concerning the relationship between DNA ploidy patterns and outcome of gastric cancer with subserosal invasion, the aneuploidy (+) group was significantly inferior to that of the aneuploidy (-) group (p<0.001). In terms of recurrent type, hepatic metastasis was dominant in the ssα and ssβ groups, while peritoneal metastasis was dominant in the ssγ group. Although subdivision of the subserosal infiltrative type according to the criteria revealed clinical and pathological characteristics, such classification could not predict their outcome. On the other hand, it is considered that analysis of DNA ploidy patterns in gastric cancer with subserosal invasion will be a useful prognostic factor.

Key words
clinicopathological characteristics of gastric cancer with subserosal invasion, DNA ploidy pattern

Reprint requests
Masatsugu Kitamura Department of Surgery, Tokyo Metropolitan Komagome Hospital
3-18-22 Honkomagome, Bunkyo-ku, Tokyo, 113 JAPAN

Accepted
April 1, 1992

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