Abstract
It is highly possible that Borrmann type 4 gastric cancer has a biological behavior which is different from that of gastric cancer of other types, from the facts that early diagnosis of Borrmann type 4 gastric cancer (scirrhous carcinoma) is difficult and that some cases of gastric cancer of this type show rapid progression. In order to investigate this possibility, 95 patients with Borrmann type 4 gastric cancer were roughly divided into Type G (69 patients) and Type P (26 patients) according to the mucosal properties of the excised specimens and were compared clinicopathologically and histochemically. Type G was mostly observed in female patients. The incidence of serosal (s) and of peritoneal (p) factors was high. The incidence of lymph (ly) factor was higher than that of the other factors, 58.0% in Type G and 65.4% in Type P, although most of the cases were advanced and the prognoses were poor. The prognosis of Type G in particular was poor, and there were no 5-year survivors. Histochemical examination revealed that cases of both Types G and P showed a large quantity of acidic mucopolysaccharides in the interstitial tissues of the tumor. However, the enzyme digestion test revealed that the quantity of hyaluronic acid and sialic acid in the interstitial tissues of Type G tumor tended to be greater than that in Type P. These facts were considered to contribute to the rapid progression of gastric cancer of Type G and to be one of the causes of the poor prognosis.
