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韓國人 胃癌의 外科病理學的 觀察

Pathological analysis of gastric carcinoma in Korean

중앙의학 1961년 1권 5호 p.525 ~ 536
白樂晥, 徐相完, 李鎬永,
소속 상세정보
白樂晥 (  ) - 서울百病院
徐相完 (  ) - 서울百病院
李鎬永 (  ) - 가톨릭 의대 병리학교실

Abstract


This article presents the result gained from surgical pathological analysis of the 100 consecutive specimen obtained on gastric resection for carcinoma in Paik Clinic from Jan. 1958 to May 1961.
1. 45% were subjected to resection for cure. The rest(55% ) received the palliative resection leaving disease behind.
2. The mode of spread were lymphatic, direct extension and peritoneal seeding, but innom of the cases, hematogenus metastasis evident.
3. By location, 83% were in antrum, 59% of them were situated in lesser curvature 8% were in cardia, and remaining 9% in the body.
4. The tumor varied in size, but 62% were between 6-10 cm in diameter.
5. Gross pathological examination of specimen showed 59% to be fairly well localized with sharp margin, while the rest(41%) had diffuse form with ill defined border. when ail these tumors were divided into 3 groups, namely.
(a) fungating form (b) penetrating form and (c) mixed form, majority(71%) were of mixed type and the rest (29%) were purely penetrating type.
There were no, cases of pure fungating type. which did not have some tendency of penetration. Ulceration of some degree were present in all cases, some (22%) deep, penetrating into muscularis, majority(78)% shallow(only sub mucosal).
When these tumors were further divided into 12 groups on gross pathological findings, 41% of the cases were classified as L. M. sh (localized mixed form with shallow ulcer) and 21% belonged to D. P. sh (diffusely penetrating form with shallow ulcer).
6. Histopathological analysis were made on the tumor in the aspects of differentiation,. amount of stroma, degree of mucus secretion, degree of neoplastic penetration into the gastric wall, and evidence of perigastric lymph nodes metastasis.
(a) Differentiation: well differentiated, moderately differentiated and anaplastic tumors were found to be 19:28 : 58 in ratio of frequency.
(b) Amount of stroma : localized form contained less stroma comparing with diffuse . form, and less differentiated tumors were generally rich in stroma.
(c) Degree of mucus secretion
There were no definite relationship between the degree of mucus secretion and the gross forms or differentiation of the tumors, while it was interesting to note that the tumors of rich in mucus secretion (so called mucoid carcinoma) revealed relatively lesser amount of stroma.
(d) In 95% of the cases, the tumors were proved histologically to have infiltrated to serosa as well as perigastric tissue and in 97% of the cases, to be positive in regional nodal metastasis.

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