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This article presents a case of advanced cancer of the transverse colon seen in an 18-year-old woman who underwent a potentially curative resection. The histological type of cancer was well-differentiated adenocarcinoma. After reviewing the clinicopathological features of 110 colorectal cancer cases in patients younger than 20 years of age compiled from the Japanese literature, the high incidence of poorly differentiated carcinoma (51.5% for poorly differentiated adeno-carcinoma, signet-ring cell carcinoma, mucinous carcinoma, and undifferentiated carcinoma) and of more advanced stages (67.1% for clinical stages IIIb and IV) were found to be characteristic for patients with colorectal cancer younger than 20 years of age. The presence of more advanced disease and the high incidence of poorly differentiated carcinoma thus seem to be related to the low postoperative survival rates. The 2-year survival rate was 19.8% and the 5-year survival rate was 8.8% in colorectal cancer patients younger than 20 years of age.

Survival was determined after resection for the two main histological types of gastric carcinoma, intestinal (n = 223) and diffuse (n = 170), in 393 patients with pT1 or pT2 tumours. Lymph node metastases were present in 94 patients. The 10-year survival rate was significantly lower for patients with intestinal-type than for those with diffuse-type carcinoma (72 versus 91 per cent, P < 0.005). In patients without nodal involvement, the 10-year survival rate was still lower for those with intestinal-type cancer (70 versus 94 per cent, P < 0.01). Recurrence of carcinoma was more often by haematogenous dissemination in patients with intestinal-type cancer. Although the results of resection for pT1 or pT2 gastric carcinoma can be acceptable, the introduction of adjuvant therapy based on histological findings may be necessary for patients with the intestinal type of cancer to prevent haematogenous spread of carcinoma to the liver.

Flow cytometric DNA analysis has been performed on tumor tissue obtained by endoscopic biopsy before and after intraarterial infusion of ADM and 5Fu. The patient was a 74-year-old woman with a gastric cancer with an involvement of a para-aortic and cervical lymph nodes. Histological examination revealed a poorly differentiated adenocarcinoma, and flow cytometric DNA analysis disclosed that the DNA ploidy (DNA index) did not differ before and after intraarterial infusion of ADM and 5Fu. The fraction of the tumor cells in the S + G2.M phase of the cell cycle however, decreased from 56% to 44% with anticancer chemotherapy. A flow cytometric DNA analysis, using biopsied samples of tumor tissue, was found to be a useful tool for monitoring the effect of anti-cancer chemotherapy for solid tumors.

This study was undertaken to elucidate those histological and gross features associated with gastric carcinoma that can be adequately treated by gastrectomy with less aggressive lymphadenectomy. The frequency of metastasis to the lymph nodes was analyzed in 514 cases of resected, solitary, gastric carcinomas. The frequency of metastasis to the lymph nodes increased in proportion to the increase in the extent of penetration by the cancer into the gastric wall. Lymph nodes were not involved in cases of intramucosal carcinoma of the intestinal type, by Laurén's histological classification. By contrast, metastasis to the lymph nodes was observed in cases of intramucosal carcinoma of the diffuse type, by Laurén's classification. We conclude that extensive lymphadenectomy is not mandatory for patients with intramucosal carcinoma of the stomach of the protruded type, since the lymph nodes do not become involved in this type of gastric carcinoma.

Determination of tissue CEA content and cytophotometric DNA analysis of colorectal mucosa were carried out in 45 patients. Tissue CEA content in mucosa of tumor-bearing patients was significantly higher than in mucosa of the controls. In mucosa of the patients, tissue CEA content of transitional mucosa was significantly higher than that of background mucosa. Cytophotometric DNA analysis of colorectal mucosa disclosed that over 3c cells were not found in the upper third of the crypt in the controls, whereas appearance of these cells in the luminal surface of the crypt was characteristic in tumor-bearing patients. The population of over 3c cells in the upper third of the crypt was significantly larger in patients with multiple cancers or cancer accompanied by adenomas, than in the patients with solitary colorectal cancer.

Serum levels of immunosuppressive substance (IS) were determined in 99 patients with gastric cancer and in 32 healthy individuals. The serum IS levels in the patients (769.6 +/- 314.8 micrograms/ml) were significantly higher than those in the healthy individuals (549.7 +/- 104.7 micrograms/ml). A multivariate analysis on the correlation between serum IS levels and clinicopathological findings in the patients disclosed that there was a close correlation between the serum IS levels and the depth of invasion, in particular, the prognostic serosal invasion, metastasis to the distal lymph nodes and peritoneal dissemination. There was, however, no correlation between the serum IS level and hepatic metastasis. Serum IS levels were higher in patients with well-differentiated adenocarcinoma than in those with poorly differentiated adenocarcinoma or signet ring cell carcinoma. A serum IS level higher than 1000 micrograms/ml indicates the possibility that the tumor is only palliatively resectable because of involvement of the distal lymph nodes or peritoneal dissemination.