[Correlation between cell-functional differentiation phenotype and pathobiological behavior of gastric carcinoma]

To demonstrate the correlation between cell-functional differentiation features and invasion, metastasis of gastric carcinoma (GC) by establishing a new classification based on cell-functional differentiation.

According to the direction and condition of cell-functional differentiation, 361 gastric carcinomas were divided into five types to show their respective pathobiological behavior.

(1) Absorptive functional differentiation type (AFDT): 22.7%(82). 13.6% of the male patients developed liver metastasis, (2) Mucin-secreting functional differentiation type (MSFDT): 15%(54). 98.1% of GC showed serosa invasion, (3) Absorptive and mucin-producing double functional differentiation type (AMPFDT): 49.9% (180). Women infliction (34.4%) and estrogen receptor (ER) expression (71.7%) in this group were more common than in the other types (P < 0.01). 19.4% of these female patients were complicated with ovarian metastasis, (4) Specific functional differentiation type (SFDT): 3.6%(13). 69.2% of these tumors derived from (high) A (amine content) + (high) P (precursor) U (uptake from the ambient medium) + (presence of) D (decarboxylase) (APUD) system and (5) non-functional differentiation type (NFDT): 8.9%(32). 59.4% developed lymphatic metastasis. The 5-year survival rates of these types were 58.5%, 28.6%, 24.7%, 60.0% and 28.1%, respectively.

This new cell-functional classification of gastric cancer is helpful by indicating their pathobiological behavior and characteristics of invasion and metastasis. Further study is needed to clarify the correlation between cell-functional differentiation phenotypes and their relevant genotypes as well as the inherent relationship between the biological behavior.