EARLY GASTRIC-CANCER IN URUGUAY

This report comprises all early gastric carcinomas (EGCs) submitted to surgery in Uruguay from 1972 to 1989. The EGC definition and type cla ssification have been carried out according to the guidelines of the J apanese Research Society for Gastric Cancer. We have included 25 perso nal cases and also several other cases on the basis of the information provided by other pathologists. We have had frequent access to the mi croscopic slides for revision as well. 15 cases were discarded due to inadequacy of sampling of the surgical specimen. 69 EGCs were detected in the surgical specimens of 64 patients. Three patients showed a sec ond independent EGC while one showed three lesions. The most frequent endoscopic types were: type IIc (slightly depressed) 36.2%, type IIc III (combined type, depressed + ulcerated) 29% and type I (protruding type) 18,8%. Three were classified as minute EGCs (5 mm or less in di ameter). 39 lesions showed neoplastic cells only in the mucosa (m type ) whereas 30 invaded the submucosal layer (sm type). EGCs with a diame ter of 10 mm (or less) showed at the microscopical level only two hist ological types: tubular well-differentiated adenocarcinoma (intestinal type) or signet ring cell carcinoma. When the ratio of EGCs versus ad vanced carcinomas was studies reviewing the pathological files of the Hospital de Clinicas, we found the EGC percentage increased continuous ly from 1981 to 1989. The median value was 16.6%. This evidence indica tes an improvement in the early detection of gastric cancer concomitan t with the better training of endoscopists. However, the medial value decreased to 4.9% when specimens from the whole country were considere d. These numbers should be compared to data obtained in Italy (8.2%) a nd Japan (32%). The frequency of different endoscopical types of EGC w as similar to the larger Japanese series and different from those publ ished in Europe. In this sense the racial and dietetic differences do not seem to have any influence over the different types of early gastr ic carcinomas detected. This fact stresses the relevance of the pathol ogical method of study in assessing the EGC characteristics.