Journal of Okayama Medical Association
Published by Okayama Medical Association

Full-text articles are available 3 years after publication.

胃癌の肝転移に関する研究 第1編 胃癌の肝転移に関する臨床的研究

黒住 公明 岡山大学医学部第1(陣内)外科教室
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1. Thirty five cases of the liver metastasis (8.9%) were found among 395 cases of gastric cancer. 2. Ascites was observed in 6 cases (17.1%) and peritonitis carcinomatosa was observed in 8 cases (22.8%) among these 35 patients with the liver metastasis. 3. Benign metastatic type, i.e. the large nodullar localized type and the false type were seen in 71.4% of all, cases and malignant metastatic type, i.e. the small nodular sporadic type was seen in 28.6%. 4. The original tumor of the liver metastatasis was found more at the lesser curvature and cardiac orifice, less at the pylorus, greater curvature and paries ventrocranialis and never at the paries dorsocaudalis. 5. The liver metastasis was found mostly in the first and the second types of Borrmann's classification of gastric cancer and never seen in the third or the fourth type except for one case. 6. Histologically, in these cases of the liver metastasis, adenocarcinoma was 74.4%, carcinoma simplex was 22.8% and scirrhus was 2.8%. 7. Compared with the cases without the liver metastasis, the original tumor of the liver metastasis more Ⅱ and Ⅲ grades of grade of growth, and leses Ⅳ or Ⅴ grade. 8. Compared with the cases without the liver metastasis, in the original tumor of the liver metastasis, typical C type was less, P type showed less progressed tendency and L type was observed in all cases. 9. Thus, the liver metastasis occurs more easily in relatively benign cancer. 10. The liver metastasis is performed by the route of the portal vein thus the site of metastasis is mostly in the sinusoid and the interlobar vein, but not in the central vein. 11. The histological patterns of the tumor emboli in the liver showed the tendency of growth in all cases, with degenerative process at the same time in 37.1%. This fact shows the tumor cells do not always form even if they reach the liver. 12. Even in the macroscopically normal part of the liver with metastasis, emboli of cancer could often be observed. Therefore, the resection of the metastatic part of the liver is less significant, for the radieal operation.