Follow-up Study of Gastric Adenomas-Comparison between Change of Tumor Size and Pathologic Findings-

Abstract

Eight hundred and ninety adenomas of 836 cases were diagnosed during the period from June, 1962 to February, 1993 at National Cancer Center Hospital. We studied relationship between changes of tumor size and pathological findings in 77 lesions (70 cases) which are followed endoscopically and histologically for more than 3 years. Fourteen (18%) lesions increased in size (increased group) and 63 (82%) lesions almost unchanged (unchanged group) .
The male was significantly dominant in the increased group, and lesions larger than 2cm or those with flat polypoid type were more frequent in the increased group. The follow up periods were various, until the increase in size was noticed.
No relationship was identified between changes of size and grades of histological atypia. Histological atypia at the first examination was not correlated with changes in size. Histological diagnosis by the method of morphometrical analysis with image processing was done for 30 lesions, 23 unchanged and 7 changed cases. In increased group, aspect ratio of nuclei was decreased and area and maximum width of tubuli were increased in the final biopsy specimens. These changes mean morphometrically rounding of nuclei and widening of tubuli in pathological findings.
At the first examination, coefficient variation of maximum width of tubuli (MWCV) was higher in the increased group (50.64) than in the unchanged group (36.95) . This finding shows that there are morphometrical difference between the two groups.
Our study suggests that 4 factors of sex, size, shape and MWCV may be helpful for predicting increase in size of the adenoma.