CLINICOPATHOLOGICAL AND IMMUNOPATHOLOGICAL STUDY OF MULTIPLE EARLY GASTRIC CANCER (DOUBLE CANCER)

Seventy-six lesions of 38 cases of multiple early gastric cancer were clinicopathologically studied, and the localization of CEA and CA19-9 in the lesions was also investigated using enzyme antibody method. Multiple early gastric cancer (double cancer) accounted for 5.5% of all resected gastric cancers, and was predominant in elderly men, and in region A and M. Macroscopically, the major lesions predominantly compresied torus type, while the minor lesions, concave type. Histologically well differentiated tubular adenoma was predominant in both lesions. Twelve of 38 (31.6%) minor lesions occupied oral-side regions from the major lesions, and 11 minor lesions were comparised of minimal size of cancers. The importance of appropriate decision of the resection area should be emphasized not to leave the minor lesions in the residual stomach. As for tumor markers, both CEA and CA19-9 were positive in all lesions of poorly differentiated cancers. On the other hand, CEA positive rates in well defferentiated cancers were 80.6% in the major and 56.3% in the minor lesions, and CA19-9 positive rates, 64.5% and 50.0% respectively. Both tumor markers showed higher positive rates in major lesions rather than those in the others, which might reflect a fact that, with the lapse of time, the cancers gradually proliferated, differentiated, and produced the tumor markers.