IS EARLY GASTRIC-CANCER, DIFFUSE-TYPE, A FORERUNNER OF ADVANCED GASTRIC-CANCER

Aims and Background: Gastric cancer (GC) represents one of the most im portant causes of death by malignancy world wilde. Our retrospective s tudy was carried out on surgical stomach specimens obtained from a ser ies of 552 consecutive cases of GC observed in the Departments of Surg ical Pathology of the Public Hospitals of L'Aquila and Atri which cove r the 17 % of the entire population of the Italian Region Abruzzo. The alm of the study was to compare the anatomo-clinical characteristics of early GC (EGC) and advanced GC (AGC). Methods: The diagnosis was ac hieved by the criteria of the Lauren's histopathological classificatio n (intestinal and diffuse types). Our study also stratified the cases by sex, age, lymph node metastases and associated lesions such as chro nic atrophic gastritis, intestinal metaplasia and dysplasia. Results: On an average, patients affected by EGC were 8.1 years younger than th ose with AGC. This age gap could support the hypothesis that early les ions represent the first stage of AGC. However, when patients were sub divided according to Lauren's classification, the mean age of patients with EGC, diffuse type, was 12.2 years less than that of AGC patients of the corresponding hisiological type. Furthermore, the subset of pa tients with EGC, diffuse type, and lymph node metastases was 17.8 year s younger than patients affected by AGC diffuse type, with lymph node metastases. Conclusions: The present study offers an original survey o n GC in a defined Italian population. As far as the intestinal histoty pe is concerned, the slight age difference between EGC and AGC suggest s that these tumors are different steps of the same process. On the co ntrary, the age distribution suggests that EGC, diffuse type, has a di fferent biological behaviour.