Clinicopathologic Study of Submucosal Invasive Gastric Carcinoma -Comparison of Intramucosal and Submucosal Histology and Study of Mucin Expression-

Hirotaka Kashimura, Masahiro Ikegami*

Department of Surgery II, Department of Pathology*, Jikei University School of Medicine

Histologic features in 176 cases of submucosal invasive gastric carcinoma were investigated. Thirty (28.5%) of 105 well-differentiated intramucosal adenocarcinomas became poorly differentiated in the submucosal layer, whereas each of the 71 poorly differentiated intramucosal adenocarcinoma had the same histological features as the infiltrate. The mode of invasion of the carcinoma to the submucosal layer and its intramucosal histologic features were correlated. Eighty-nine percent of poorly differentiated intramucosal adenocarcinomas had invaded the submucosal layer in a nonsolid manner, whereas 65% of well-differentiated intramucosal adenocarcinomas had spread in a solid manner. Five of 18 patients (28%) in whom the histologic diagnosis had changed from well-differentiated adenocarcinoma to poorly differentiated carcinoma with solid spread from the intramucosal to the submucosal layer died of the disease and tended to have intestinal-type mucin. Patients with these histologic features are at a high risk for recurrence and should receive adjuvant therapy, even if they have undergone curative resection for early gastric carcinomas.

Key words
gastric carcinoma, submucosal invasive gastric carcinoma, intramucosal histology of gastric carcinoma, submucosal histology of gastric carcinoma, mucin histochemistry of gastric carcinoma

Reprint requests
Hirotaka Kashimura Department of Surgery II, Jikei University School of Medicine
3-25-8 Nishishinbashi, Minatoku, Tokyo, 105 JAPAN

Accepted
October 9, 1996

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