<b>Clinicopathological significance of gastric poorly differentiated medullary car</b><b>cinoma </b>
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- HIRAI Hideaki
- Departments of Pathology and Bioscience, Hirosaki University Graduate School of Medicine
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- YOSHIZAWA Tadashi
- Departments of Pathology and Bioscience, Hirosaki University Graduate School of Medicine
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- MOROHASHI Satoko
- Departments of Pathology and Bioscience, Hirosaki University Graduate School of Medicine
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- HAGA Toshihiro
- Departments of Pathology and Bioscience, Hirosaki University Graduate School of Medicine
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- WU Yunyan
- Departments of Pathology and Bioscience, Hirosaki University Graduate School of Medicine
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- OTA Rie
- Departments of Pathology and Bioscience, Hirosaki University Graduate School of Medicine
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- TAKATSUNA Masafumi
- Departments of Pathology and Bioscience, Hirosaki University Graduate School of Medicine
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- AKASAKA Harue
- Departments of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine
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- HAKAMADA Kenichi
- Departments of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine
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- KIJIMA Hiroshi
- Departments of Pathology and Bioscience, Hirosaki University Graduate School of Medicine
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抄録
Poorly differentiated gastric adenocarcinoma of solid type is known to show a clinicopathological diversity, but its morphological characteristics have rarely been investigated. In this study, we defined poorly differentiated medullary carcinoma indicating the following three characteristics: (i) more than 90% of the entire tumor were composed of poorly differentiated adenocarcinoma in a medullary growth, (ii) the tumor exhibited an expansive growth at the tumor margin, and (iii) special types such as an α-fetoprotein-producing carcinoma, neuroendocrine carcinoma, and carcinoma with lymphoid stroma were excluded. Based on the definition, we subclassified the poorly differentiated gastric adenocarcinoma of solid type into the two groups: medullary carcinoma and non-medullary carcinoma, and clinicopathologically analyzed 23 cases of medullary carcinomas and 38 cases of non-medullary carcinomas. The medullary carcinomas less frequently displayed lymphatic invasion, venous invasion, and lymph node metastasis, compared with the non-medullary carcinoma (P < 0.001, P = 0.002, and P < 0.001, respectively). The patients with medullary carcinomas significantly showed better disease-free survival (P = 0.017). This is the first study to demonstrate that poorly differentiated adenocarcinoma of solid type can be subclassified into tumors with low and high malignant potentials. Gastric poorly differentiated medullary carcinoma is considered to be a novel histological type predicting good patients’ prognosis.
収録刊行物
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- Biomedical Research
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Biomedical Research 37 (2), 77-84, 2016
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