조기 위암에서 점막암과 점막하층암의 임상 병리학적 비교
Are There Any Clinicopathologic Differences between Mucosal and Submucosal Cancer of Stomach?
대한암학회지 1994년 26권 3호 p.385 ~ 391
소속 상세정보
정병화
박조현/오승택/이종서/박우배/김병기/주상용/김인철
KMID : 0360319940260030385
Abstract
From 1980 through 1991, 1729 patients underwent operation for gastric cancer at Department of Surgery, Catholic University Medical College in Seoul, Korea. Three hundred and twelve patients (18.0%) were early gastric cancer (EGC): mucosal cancer
were
107 cases (34.3%) and submucosal cancer were 205 cases ( 65.7%). The purpose of the present study was to compare the clinicopathologic features of EGC between mucosal cancer and submucosal cancer. Submucosal cancer developed in older age than
mucosal
cancer (average 55 vs 49 years old). No differences, however, were noted in clinical manifestations and duration of symptoms.
Macroscopically, elevated lesions (type I or Ⅱa predominant) were frequently encountered in submucosal cancer than mucosal cancer (24.6% vs 9.7%). Histologically, differentiated carcinoma or intestinal type by Lauren's classification was more
common in
submucosal cancer than mucosal cancer. The incidence of lymph node metastasis of EGC was 15.1% (47/312); 2.8% (3/107) in mucosal cancer and 21.5% (44/205) in submucosal cancer. Lymph node involvement of submucosal cancer was significantly higher
in
patients with elevated lesions (35.3%) than in depressed lesions (13.5%). No lymphatic or venous invasion was noted in mucosal cancer. In submucosal cancer, however, incidence of venous and lymphatic invasion was 7.2% and 20.3%, respectively.
Kaplan-Meier estimates for-5-year survival were 98% for mucosal lesions and 79% for submucosal lesions (overall 5-year survival rate; 86.3%). The 5year survival rate in patients of submucosal cancer with lymph node metastasis was only 60%
compared
with
88.5% in patients of submucosal cancer without lymph node involvement. All recurrent cases were submucosal cancer patients. Six out of the 9 recurrent patients were macroscopically elevated type and had lymph node metastasis. The authors conclude
that
there is definite difference in terms of clinicopathologic findings between mucosal and submucosal cancer of stomach even though EGC includes both lesions by definition. So, therapeutic approach of submucosal cancer should be different from
mucosal
cancer.
@TE The Inhibitory Effects of Allyl Sulfide and Indole-3carbinol on N-methyl-N-nitro-N-nitrosoguanidine-induced Glandular Stomach Carcinogenesis in Rats
@AU 김대중, 이국경, 배종희, 장자준, Chie Furihata, Masae Tatemastu
@PG 392
@EN 한국인의 상용식품인 마늘의 주성분인 allyl sulfide(AS) 및 양배추의 주성분인 inodole-3-carbinol (I3C)의 랫드의 위암발생 수식효과를 위암전암지표인 pepsinogen 1 altered pyloric glands(PAPG)를 이용하여 검색하였다. 80수의 수컷 Wistar계 랫드를
다섯군으로
나누었다. MNNG 단독투여군, MNNG+AS 및 MNNG+I3C 투여군에는 N-methyl-N'-nitro-N-nitrosoguanidine(MNNG)를 kg당200mg씩 1회 위내로 투여하였다. 각각의 대조군에 대하여는 MNNG 대신에 10% DMSO용액 1ml씩을 위내로 투여하였다. MNNG 단독투여군은 20주간
기초사료를,
MNNG+AS 및 AS 투여군, MNNG+I3C투여군은 0.2% AS 또는 0.25% I3C 함유사료를 실험 2주부터 18주간 계속 투여하였다. 모든 실험동물은 실험시작 20주에 24시간 절식시킨후 부검을 실시하였다. PANG를 위한 면역조직화학적 염색을 위하여 승홍포르말린에 선위
유문선부를
고정하였다. MNNG+AS 또는 MNNG+13C 투여군의 PAPG의 수에 있어서 MNNG 단독투여군에 비하여 유의성있게 감소하였다. 따라서 AS 및 I3C은 MNNG에 의해서 유발된 랫드 선위 위암발생에 있어서 억제효과가 있는 것으로 사료된다.
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