Abstract
Spreading and malignancy of gastric cancer might be decided according characteristics of submucosal infiltration and intramucosal spreading of cancer. Type of submucosal infiltration (sm-type) was calculated by the histological findings based on the above thought and the prognosis of patients was evaluated. The extent of submucosal infiltration (sm) was decided by the comparison cf intramuccsal spreading (m), and its criteria is as follows;
sm1: The extent of submucosal infiltration (sm) is the slightest compared with the intramucosal spreading. (sm<m)
sm2: The extent of submucosal infiltration is nearly same as the intramucosal spreading.
(sm=m)
sm3: The extent of submucosal infiltration is greater than the intramucosal spreading.
(sm>m)
sm4: The extent of submucosal infiltration is the greatest. (sm>m)
444 resected cases with gastric cancer were evaluated their prognosis for more than three years.
Results:
1) Cases with infiltration of deep layer of gastric wall were increased with the increase of sm-number, and majority cases of far advanced gastric cancer were sm2 and sm3. That is to say, the characteristics of submucosal infiltration may suggest the mode of infiltration of deep layer of gastric wall.
2) The correlation between sm-type and the prognosis of patients were studied in 268 cases with curative resection, and the significant correlation was found. The prognosis of patients with sm1, sm2, sm3 and sm4 were 90%, 56%, 28% and 0% respectively. The relation between sm-type and the grade of infiltration of gastric wall was studied, and the prognosis of patients was good in sm1 and poor in sm2, sm3 and sm4 even though the grade of infiltration of gastric wall was the same. For instance, prognosis of patients with sm1 was 87% and those of sm2 and sm3 were 30% in patients with serosal infiltration whose prognosis was 33%. That is to say, the significant correlation was found between sm-type and grade of infiltration of gastric wall.
3) Those tendency was significantly found in patients who were classified by Borrmann's classification and the stage of disease.
Summary:
Although the prognosis of patients with gastric cancer are evaluated by various factors, we propose the sm-type, because Borrmann's classification can not say the grade of infiltration of gastric wall and grade of infiltration of gastric wall can not guess the difference of prognosis of patients with the sane trace. Hcvrever, sm-type may tell the prognosis of patients quite exactly.
