Abstract
The author studied upon the Adenocarcinoma (Ad. Ca) and Carcinoma Solidum Simplex (Ca. SS) of the stomach in comparison of forty-three carcinomas of the cardia with fifteen usual carcinomas of the stomach which were proved intramural esophageal invasion. The purpose of the study is to grasp the histological patterns of the intramural esophageal extension of carcinoma of the stomach, the oral distance of the invasion of carcinoma, the oral resection line and the correlation between the histological view and the site of origin.
Results were as follows:
(1) The 96.2 % had a histologic diagnosis of the Ad. Ca as differentiated carcinoma and the only 3.8 % had the Ca. SS as undifferentiated carcinoma, among those tumors the center were within 3cm from the Esophago Cardiac Junction (ECJ) and also the size within 40 cm2.
(2) The submucosa and the propria mucosa of the esophagus were mostly invaded by the stomach cancer. The place of origin, the types of Borrmann the histological patterns and the changes of the esophageal mucosa did not associated with the patterns of the intramural esophageal invasion of the stomach cancer.
(3) The oral distance of the esophageal invasion of the stomach cancer was very much correlated with the types of Borrmann, the histological patterns, the shape of the oral edge of carcinoma and the changes in the mucosa of esophagus, but was not correlated with the size of the tumor.
(4) The resection line of esophagus from ECJ during operation demands about 45 mm for the crcinoma of the cardiac portion and about 30 mm for the usual stomach cancer, the former satisfies 97.8 % of ow (-) and the latter 93.3 %.
(5) In case of the carcinoma (in case of the usual carcinoma, the center of which occupies under cardia), about 25 mm (20 mm) of the oral resection line of the esophagus is necessary for Borrmann 1 and 2, about 35 mm (20 mm) for Borrmann 3, and about 45 mm (30 mm) for Borrmann 4.
(6) From the view point of histological pattern, there still leave much room for consideration. Namely, the resection line is decided about 20 mm (20 mm) for Ad. Ca. Pap, about 30 mm (30 mm) for Ad. Ca. tub. SS were needed.
(7) According to the oral edge of tumor, about 25 mm (25 mm) for the type of A and N, and about 45 mm (30 mm) for the type of P and U were needed.
(8) Concerning the changes of the esophageal mucosa which covers the tumor, about 15 mm (25 mm) for the hypertrophy about 25 mm (15 mm) for the unchanged, and about 45 mm (30 mm) for the atrophy were needed.
