Early gastric carcinoma in Japanese patients under 30 years of age

Abstract

The clinicopathological characteristics of early gastric carcinoma (EGC) in 23 Japanese under 30 years of age were reviewed and the findings compared with data on 53 patients over age 70. In the young patients, there was a female preponderance, a macroscopic solitary lesion and the cancer was of the poorly differentiated type without intestinal metaplasia in the surrounding mucosa. In the old patients, there was a male preponderance; about half the number of patients had macroscopically elevated lesions and 10 of the 53 had a multifocal gastric carcinoma. Here, most lesions were well to moderately differentiated types with intestinal metaplasia in the surrounding area. Growth patterns of EGC in the young patients were analysed. Curative operations with dissection of regional lymph nodes were done in all the young patients. Metastases to the regional lymph nodes were present in only 2 of 23. Twenty of twenty-three followed for 5 years or longer are well.

Intramucosal gastric adenocarcinoma of poorly differentiated type in the young is characterized by Helicobacter pylori infection and antral lymphoid hyperplasia

“…With regard to glandular atrophy and intestinal metaplasia of the background mucosa, our young patients were mostly infected by H. pylori, however, they had less degree of corporal glandular atrophy and less frequent intestinal metaplasia around the intramucosal gastric cancer than elderly patients did. This result is consistent with that of the previous report by Mori et al 2 On the other hand, Koshida et al 18 reported that there was significantly higher prevalence of H. pylori infection, glandular atrophy and intestinal metaplasia in cases with gastric cancer than in cases without gastric cancer in young patients. This result is not consistent with the above ones including ours, however, Koshida et al 18 treated with patients younger than 40 years old (total of 40 patients, including only nine patients under 30 years of age).…”

“…In several studies, the clinicopathological features of gastric cancer in the young were somewhat different from ours. 1,2,[9][10][11][12][13][14]3,[15][16][17][18][19] With regard to histological type, poorly differentiated adenocarcinoma tends to be more frequent in young adults, [12][13][14]3 however, there is no difference in sex distribution between the young and elderly patients. 9,10,13,14 The discrepancy (b) Fifty-seven-year-old male subject (same case as a).…”

“…1,2 In an analysis of 107 young patients aged 30 years or less, Nakamura et al 1 from our department reported that the prevalence in female subjects was more frequent than in males, that poorly differentiated adenocarcinoma was more frequent than welldifferentiated adenocarcinoma, and that cancers occurred more frequently in the middle third of the stomach, when compared to cancers in the elderly patients. These observations conform to those reported previously, [1][2][3] and these characteristic clinicopathological features suggest that gastric cancer in young patients occurs under peculiar conditions.…”

“…4,5 Although H. pylori infection has been shown to be closely associated with the occurrence of welldifferentiated adenocarcinoma in the stomach of middle-aged or elderly patients, 6 the contribution of the infection to the development of gastric cancer in young patients has not been elucidated, simply because the incidence of gastric cancer is low in the young. 1,2,7 Even in pathological investigations, there have been only sparse data regarding the characteristics of the background gastric mucosa in young patients with intramucosal gastric cancer. In this study, we investigated the background mucosa of intramucosal gastric cancer in a young group and compared them with those in an elderly group with identical histology and invasion depth.…”

Early gastric cancer mimicking advanced gastric cancer

“…Early gastric cancer (EGC) now accounts for over 50% of all gastric malignancies in most Japanese hospitals (Hioki et al, 1990;Maehara et al, 1992). As these incidences have increased, the clinicopathological features of EGCs have been gradually elucidated by various authors (Mori et al, 1985;Ohta et al, 1987;Moreaux et al, 1993). The accumulation of patients with EGCs has allowed the investigation of atypical EGCs (Noguchi et al, 1985;Ichiyoshi et al, 1990; Kitamura et al, 1996a); early gastric cancers mimicking advanced gastric cancers (EGC mimicking AGC) is one such variant.…”