胃癌と腸上皮化生の関係 : AH粘膜染色および組織学的検討による

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The presence and extension of intestinal metaplasia (IM) can be grossly and reliably recognized in resected and formalin fixed stomachs by alcian blue -hematoxylin (AH) mucosal staining. I investigated the degree of IM development and the spatial relationship with carcinomas of different histological types using this method in 307 surgically resected specimens harboring 401 early carcinomas [294 well differentiated carcinomas (WDCs) and 107 poorly differentiated carcinomas (PDCs)]. Further, I examined on which side of the tumor, anal or oral, the IM was more frequent, as well as the type of IM, complete or incomplete, using 95 carcinomas from 80 stomachs. Although most (90%) WDCs were found in stomachs with moderate or severe IM, at least 20% of the tumors were clearly surrounded by mucosa with. little or no IM. In contrast, 54% of PDCs, generally believed to develop in normal or non-metaplastic mucosa, were located in stomachs with moderate IM, and nearly 60% were associated with metaplastic mucosa, as in the WDC case. Further, IM was in general more frequent on the anal side of the tumors, and the type depended on the tumor's location, i.e., tumors in the antrum were surrounded by mucosa with mixed complete and incomplete type IM, while those in the body were predominantly associated with complete type IM. The present findings indicate that IM is frequent not only in stomachs with WDC, but also together with PDC, where the IM is suspected to surround the tumor during the course of its development. The extent and type of IM in the mucosa around tumors depends on the tumor location. Thus, as an indicator of risk of development of gastric carcinoma, IM should perhaps be considered a general rather than a local factor. In addition, no clear relationship exists between incomplete type IM and carcinomas.
東京女子医科大学の論文
1998-02-25

胃癌と腸上皮化生の関係 : AH粘膜染色および組織学的検討による

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