DISTINCT CLINICOPATHOLOGICAL CHARACTERISTICS OF DIFFUSE-TYPE AND INTESTINAL-TYPE GASTRIC-CANCER IN TAIWAN

The clinicopathologic features of 221 patients with intestinal-type (I T) gastric cancer were compared retrospectively with those of 290 diff use type (DT). Intestinal type was characterized by an older mean age (65.0 +/- 10.8 years vs. 56.2 +/- 13 years), a higher male-female rati o (2.56 vs. 1.06), predominance of blood group O (46.2% vs. 31.1%), an d frequent habitual smoking (50.7% vs. 31.4%) and drinking (28.5% vs. 17.6%) than did DT. In contrast, DT had a higher frequency of positive history of parent or sibling with gastric cancer (9.3% vs. 4.1%) and blood group A (40.3% vs, 27.6%) than did IT. The distinguishing histol ogic features of DT included more Borrmann type IV (13.1% vs. 1.3%) bu t less Borrmann type I (1% vs. 7.2%), more frequent involvement of mid dle third (26.9% vs. 15.9%) and whole stomach (4.1% vs. 0%), and more peritoneal seeding (15.5% vs. 9%), lymph node metastasis (67.2% vs, 51 %), and nerve permeation (34.1% vs. 24.4%), but less Helicobacter pylo ri infection (55.9% vs. 69.2%) when compared with those of IT. There w as no difference in depth of tumor invasion, venous permeation, duoden al involvement, and postoperative survival between IT and DT. These di stinct clinicopathologic features between IT and DT in Taiwan suggest the presence of a different pathogenic process for these two histologi c subtypes of gastric cancer.