胃癌的异质性及其组织发生

本文选择胃癌、胃良性病变、尸检胎儿及足月新生儿的胃标本,分别作粘液组化。M—E染色,并应用光镜和电镜进行对照观察。胃癌异质性表现在同一病例有多种组织学类型;癌组织出现多种类型粘液;癌细胞形态不一,胞浆内可见各种不同类型的分泌颗粒、酶原颗粒、内分泌颗粒、粘液颗粒;粘液颗粒还可通过不同方式向外排出;所有胃癌病例均可见多寡不等含微丝束之微绒毛等。我们通过胎儿胃上皮演变过程的对比观察,发现各种类型胃上皮均来自未成熟的粘液细胞,相当于成人的胃颈粘液细胞。胃癌亦是源发于颈粘液细胞,肠型胃癌的发生也不一定必须经历肠上皮化生的中间阶段。

Heterogeneity and histogenesis of gastric carcinoma

In order to investigate the histogenesis of gastric carcinoma, the following specimens were studied with light microscopy, mucin histochemistry and electr- on microscopy: I, 19 cases of gastric carcinoma; 2, non-malingnant conditions including gastric ulcer, duodenal ulcer and superficial gastritis; 3, normal ga- stric mucosa taken from abortive fetuses and newborns died during difficult del- ivery. Results 1. Most cases of gastric carcinoma are very heterogeneous. They usually contain more than one histologic types and three types of mucin (sialomucin, suphomucin and neutral mucosubstances). The tendency towards intestinal differentiation (goblet cell typed-mucous granule and microvilli with a central core) could be found in most cases including diffuse type carcinoma. 2. we could not confirm any close relationship between gastric carcinoma and the colonic typed-intestinal metaplasia. 3. In the fetal stomach, all types of epithelial cells including the endocrine cells originate from the immature mucous cell, which is the counterpart of the neck mucous cell in the adult stomach. 4. The transient appearance of microvilli with a central core on the immature mucous cells in the fetal stomach could be considered as an evidence of the close hitogenetic relationship between stomach and intestine. 5. All types of gastric carcinoma including the intestinal type might originate from the neck mucous cell.