GOBLET CELL CARCINOIDS OF THE APPENDIX - A STATISTICAL EVALUATION OF THE BIOLOGICAL BEHAVIORS IN 170 CASES COLLECTED FROM THE LITERATURE ASCOMPARED TO 456 ORDINARY TYPE APPENDICEAL CARCINOIDS

A total of 631 cases of appendiceal carcinoids reported in the literat ure were collected mainly from the United States, Europe and Japan, an d 626 cases consisting of 170 goblet cell varieties (Group A) and 456 conventional type carcinoids (Group B) were selected for a statistical comparison from the standpoint of their clinicopathological features and biological behaviors in relation to their histologic characteristi cs. A statistically significant difference (p < 0.01) between these tw o groups was found in the male/female ratio and age-distribution, the incidence and sites of metastases and the invasive nature to the mesoa ppendix. The concept, definition and criteria of mucus-producing carci noids of the appendix were also reevaluated, and an attempt to elucida te the categorization of goblet cell carcinoids was undertaken. Assumi ng that a large number of conventional type carcinoids have been known to produce mucous substance at a varying degree, mucus-producing carc inoids were defined as gut-endocrinomas exhibiting a significant amoun t of mucus-production with characteristics amid those of a conventiona l carcinoid and an ordinary adenocarcinoma. An additional reevaluation was attempted on the related nomenclature with an identical entity of these neoplasms. Goblet cell carcinoids were considered to be an atyp ical variety of carcinoids belonging to a type of composite gut-endocr inomas. They may play an important role as one of the ideal tools to c larify the mechanism of histogenesis of gut-endocrinomas and ordinary carcinomas.