Different characteristics of carcinoma in the gastric remnant: Histochemical and immunohistochemical studies

Seventy cases of cancer of the gastric remnant were divided into three grou ps: 33 cases following surgery for benign disease (group A), and 15 cases o ccurring more than 10 years and 22 cases occurring within 10 years after th e first gastrectomy for malignant disease (groups B and C, respectively). T hen mucin histochemical and immunohistochemical studies were undertaken. Bi llroth-II procedure for anastomosis was most frequently performed in group A. Intestinal metaplasia within the mucosa surrounding the carcinomas was m ore frequently present in groups A and C with a diffuse distribution. Intes tinal-type surrounding mucosa was significantly more frequent in group C. T he immunohistochemical expression of p53 protein was most frequently expres sed in group B. We conclude that a different mechanism of carcinogenesis ex ists in these three groups; i) Group A: the reflux of duodenal juice especi ally following B-II procedures leads to progression of the carcinoma. ii) G roup B: some genetic factor such as p53 may be related to the metachronous multiple carcinogenesis. iii) Group C: metachronous multiple carcinogenesis within the short interval may be closely associated with diffuse intestina l metaplasia in the surrounding mucosa.