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Background: The clinicopathological features of mixed-type (MT) early gastric cancer (EGC) according to Lauren's classification remain uninvestigated. This study aimed to clarify the clinicopathological features of MT EGC, particularly in relation to lymph node metastasis (LNM) and long-term survival.Methods: This study included 5309 patients who underwent gastrectomy for EGC. The clinicopathological features, LNM, and long-term outcomes of patients with MT carcinomas were compared with those of patients with intestinal-type (IT) and diffuse-type (DT) cancers. Furthermore, we evaluated the predictors of LNM in each Lauren classification subgroup.Results: Patients with MT carcinomas were likelier to have larger tumors, submucosal invasion, lymphovascular invasion, and LNM than those with IT or DT carcinomas. Multivariate logistic regression analysis revealed that the Lauren classification was a significant predictor of LNM (P < 0.001). The significant predictors of LNM in MT carcinomas were female sex, greater tumor size, presence of submucosal invasion, and lymphovascular invasion. However, the overall survival of patients with MT carcinoma was not significantly different from that of patients with IT or DT carcinomas (P = 0.104).Conclusions: The presence of MT EGC carries a higher risk of LNM compared with the presence of IT or DT carcinomas. Therefore, MT carcinomas should be managed with gastrectomy that includes lymph node dissection instead of endoscopic resection. [ABSTRACT FROM AUTHOR]

A clinicopathological study of gastric carcinoma was carried out according to Lauren's classification, on 207 patients, who underwent gastric resection at Department of Surgery II, Kyushu University, Faculty of Medicine from 1970 to 1972. Among them 93 cases (44.9%) were of intestinal-type carcinoma, 71 (34.3%) of diffuse carcinoma and 43 (20.8%) of other types. Intestinal-type carcinoma, often showing the protuberant type, was more common in the aged and in men. Most had a low grade of penetration, while in some, the penetration was moderate to high grade and was associated with lymph node metastasis, lymphatic and vascular involvement, or liver metastasis. Hematogenous recurrence was not infrequent. Diffuse carcinoma was more common in younger subjects and women, and was often of the depressed type. The serosa was involved in most cases. High grade penetration was associated with lymphatic permeation. Metastasis via the bloodstream was infrequent. Recurrence was often due to peritoneal dissemination. A better prognosis was indicated in cases of diffuse carcinoma with no serosal involvement, while prognosis in cases of invasion of the serosa was worse for diffuse carcinoma than for intestinal-type carcinoma. [ABSTRACT FROM AUTHOR]

Gastric carcinomas are divided into two types according to Lauren's classification: intestinal and diffuse types. Polyamines (putrescine, spermidine, and spermine) are polycations involved in neoplastic growth of gastrointestinal mucosa. A key role is also played by ornithine decarboxylase, the rate limiting enzyme in polyamine metabolism. Our aim was to investigate whether there were differences between the two types of tumor in polyamine metabolism. Twenty-seven patients with gastric carcinoma entered the study. Seventeen carcinomas were classified as diffuse type and 10 as intestinal type. Polyamine levels were evaluated by high-performance liquid chromatography. Ornithine decarboxylase activity was measured by a radiometric technique. Polyamine levels and ornithine decarboxylase activity were significantly higher in intestinal type samples than diffuse type samples. A similarity of polyamine levels in intestinal type samples with levels previously observed in patients with colorectal adenocarcinoma was also found. These findings show a different proliferative behavior of these two types of tumor, and therefore different therapeutic strategies can be hypothesized. [ABSTRACT FROM AUTHOR]

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Copyright of Langenbecks Archiv fuer Chirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)