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The Korean Journal of Pathology 1978;12(2): 117-126.
양성 및 악성 위점막병변의 세포병리학적 진단에 관한 연구
The Study on Cytopathologic Diagnosis in Benign and Malignant lesions of the Stomach
ABSTRACT
In order to evaluate cytologic diagnosis in benign and malignant lesions in the stomach, 91 unfixed gastrectomized specimen were studied, which were submitted to department of pathology, Chungnam National University School of Medicine from January 1976 to September 1976. The cytologic smears were taken from central portions and margins of the ulcer of the lesions, and compared with that of histologic pattern, with clinical consideration. The results obtained were as follows ; 1) 91 cases were consisted of 40 carcinomas (44.O%), 39 benign peptic ulcers (42.9%) and 12 gastritis with other diseases (13.1%). 2) Among gastric carcinomas, there were noted 4 early gastric cancers originated from primary chronic peptic ulcers, which were not detected clinically. 3) Sex distribution of stomach cancer was 26 males (65%), and 14 females (35%) having 1.9 : 1 ratio. Age distribution of stomach cancer was showing the highest in 6th decade ; 23 cases (57.5%). 5th decade ; 10 cases (25.0%), and more than 80% were noted from 40 year to 60 year-old age groups. 4) Sex distribution of chronic peptic ulcer was consisted mainly of male cases showing 37 cases of a total 39 patients(94.9%). Age distribution was the highest in both 4th decade 12 cases (30.8%), and 12 cases (30.8%) in 5th decade. 5) The average diameter of malignant ulcers was 3.0-3.9cm in 14 cases(35.0%), and 6 cases were more than 5.0cm in diameter. In benign peptic ulcer, most frequent average size was 1.0-1.9cm in 16 cases (4l.0%) and there was no case measuring over 5.0cm in diameter. 6) The most malignant ulcers were located along the lesser curvature of the greater curvature of the stomach. The peptic ulcer, also, were located most frequently along the lesser curvature of the anturm in 32 cases (82.1%). 7) Cytologic diagnosis smeared from center and margins of the malignant ulcers was positive in 85%, but that smeared from peripheral portions of the lesion was positive only in 27.5% of cases. 8) The positive diagnosis in well differentiated and moderately differentiated type of the stomach cancer was 100%, and showed one case of pseudonegative in 18 cases of poorly differentiated type. 9) The doubtful cytologic diagnosis in chronic peptic ulcers was 16 cases (4l.0%), and those were associated with chronic gastritis or with marked intestinal metaplasia with atypical glandular hyperplasia.