HISTOLOGICAL FINDINGS IN GASTRIC MUCOSA AND SHICHIJO'S REACTION

Abstract

Shichijo's reaction, a biological test for diagnosis of gastric diseases, is known to give fairly high percentage of positivity in gastric cancer. The author performed gastric biopsy with 415 cases using a fiber-gastroscope, and compared histological findings in gastric mucosa with Shichijo's reaction. Surgical specimens were also examined in some cases. In thes subjects tested were included 33 cases of early gastric cancer. The findings obtained were as follows : 1) In the advanced gastric cancer, the positive group of Shichijo's reaction (inclusive of theintermediate type) accounted for 18 of the total 24 cases (75%), that was significantly higher than in benign gastric diseases : 23.3% in gastric ulcer, 16.5% in gastric polyp, and 15.4% in gastritis. These results were approximately equal to the previous reports.In the early gastric cancer, the positivity rate was 8 of 33 (24.2%), and many (21 of 33, i.e. 63.6%) gave type III and IV, the total cases of type III to IX of shichijo's reaction accounting for 29 of 33 cases (87.9%). In applying Shichijo's reaction as a screening test for gastric cancer in social wide examinations, it should therefore be better to include all the cases of type III to IX for detailed examination.3) Early gastric cancer, giving the intermediate and the positive type of Shichijo's reaction, frequently occurred in those of the protruding and the concaving type by the endoscopic classification (5 of 6 cases, i. e. 83.8%), whereas the negative type was frequently observed in those of the superficial flat type (22 of 25 cases, i. e. 88.8%).4) Pathohistological classification and developed sites of gastric cancer did not give any relation with types of Shichijo's reaction, but the depth of the cancer cell infiltration was related with the positivity; especially in cases with the muscular layer invaded the positivity rate was much high.5) Shichijo's reaction was not used as a supplementary method in differentiation of early gastric cancer from benign gastric diseases resembling it, since no differnce was od-served between them in any type of Shichijo's reaction.6) Relation- between stages of benign ulcer (which were assumed from histological findings of gastric biopsy specimens) and Shichijo's reaction was observed. It was found that the positivity was relatively higher in the almost healed and the scar stage ulcer.7) Some morphological classifications of polyp-like lesions and various gastritis had to definite relation with Shichijo's reaction, excepting the superficial nature of the former; in polyp-like lesions with rough surface, the positivity rate was higher than in those with smooth surface.