Study on Nuclear DNA and Cancer-related Gene in a Case of Early Gastric Cancer Complicated with Virchow Metastasis

Keisuke Matsusaki, Tomohiro Tada, Katsutoshi Yoshida, Toyokazu Kawano, Osamu Miura, Yoshikazu Minamisono, Susumu Nagasaki, Wataru Yasui

Institute of Gastroenterology of Hofu
*First Department of Pathology, Hiroshima University School of Medicine

We had a patient with early gastric cancer who died of carcinomatous peritonitis 5 months after surgical resection. Metastasis of the cancer to virchow's lymphnode had already occurred at the time of detection, and the resected sample was examined for cancer-related genes and nuclear DNA ploidy. In Japan, only 5 cases of Virchow metastasis of early gastric cancer have been reported so far and this might be the first one examined for the cancer-related genes. The patient was a 50-year-old woman who was diagnosed as having early gastric cancer by gastroscopy and an operation was performed. At the time of hospitalization, small lymph nodes were palpable in the epi-clavicular cavity from the left jugular portion, and were pathologically diagnosed metastasis of the cancer during the operation. In this particular case, while a IIa lesion of 35×28 mm in size was found with the cancer itself remaining in the mucosal layer, there was marked tumor involvement in the lymphatic vesels in the submucosal layer. The DNA ploidy pattern was aneuploid, and the expression of nm23, a candidate metastasis-suppressor gene, was reduced. Overexpression of c-erb B-2 was detected in both the primary and the metastatic tumors. Cancer cells in the lymphatics and the metastatic focus showed stronger expression than in the primary focus, suggesting involvement of the lymph node metastasis.

Key words
early gastric cancer with Virchow metastasis, cancer-related genes, nuclear DNA analysis

Reprint requests
Keisuke Matsusaki Institute of Gastroenterology of Hofu
14-33 Ekiminami-Machi, Hofu-City, 747 JAPAN

Accepted
January 10, 1996

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