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Abstract
The materials used in this study consist 744 gastric resections removed subtotally at the Yonsei University College of Medicine and Severance Hospital during the last 11 years from Jan. 1. 1959 to Dec. 31, 1969. Among these, 446 cases of gastric carcinoma were diagnosed at the Department of Pathology Yonsei University College of Medicine for this same duration. Histopathological studies as well as clinical study on all cases were performed.
Summary:
1. Among 744 gastric resections examined during the last 11 years, gastric carcinoma was found in 446 cases, giving an incidence of 59.95% for subtotally removed stomachs.
2. Male to female ratio was 2.28 to 1. The peak age incidence is between 50 and 59 years and accounted for 172cases(35.77%).
3. There is no relation between blood group and incidence of gastric carcinoma.
4. Clinical symptoms in order of frequency were as follows: epigastric discomfort and pain(86%), indigestion(66.67%), weight loss(35.67%), nausea and vomiting(35.33%) and palpable epigastric mass(23.33%). The duration of the chief complaints was usually within six months(54.66%).
5. The gastric acidity disclosed that achlorhydria was found in 36.21%, hypochlorhydria in 32.26% and hyperchlorhydria in 2.15%.
6. The location of the tumor was as follows: 44.86% at the pyloric canal, and 26.53% at the antrum. The size of the tumor varied in diameter. The most frequent size was 3-5cm (43.43%) and 6-10cm(42.90%).
7. On the macroscopical examination, the classification based on Borrmann's gross types and their incidences were as follows: Type I(3.71%), type II(11.22%), type III(62.18%), and type IV(23.64%).
8. On the histological classification, 70% of the cases were adenocarcinomas. Serosal involvement was found in most cases(86.89%).
9. Metastasis to the regional lymphnodes was found in 68.84%, and direct extension of the omentum was 21.39%.
10. According to the relationship between regional lymphnode metastases and lymphatic permeation, and relationship between lymphatic permeation and histologic type, the degree of lymphatic permeation is more, the more metastases to regional lymphnode is found. And metastasis to regional lymphnode and lymphatic permeation is more common in adenocarcinoma than other types.
11. There is no relationship between intestinal metaplasia and histologic type. But each histologic type was accompanied by intestinal metaplasia frequently.
In conclusion based on the above findings, it can be stated that gastric carcinoma among Koreans exhibited a far advanced stage, both clinically and morphologically.
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