The intramucosal cysts of the stomach. VII: A pathway of gastric carcinogenesis?

Gastric specimens from 259 patients (69 Swedish and 190 Japanese) were examined for the presence of intramucosal cysts. The number of cysts for each centimeter of mucosa analyzed (cystic index) was calculated. The material included 153 patients with peptic gastric ulcer, 41 with elevated dysplasias, and 65 with early gastric cancer. The results demonstrated that in the Japanese material, the normal-looking gastric mucosa adjacent to a variety of gastric lesions such as gastric peptic ulcer, focal elevated dysplasias, or incipient adenocarcinomas, had a significantly higher cyst index than the gastric mucosa adjacent to similar lesions in Swedish patients. At this point, it should be stressed that the Japanese have a high incidence of gastric cancer (82/100,000 males) while the Swedish have a relatively low incidence (28/100,000 males). The results presented herein appear to suggest that cystic formation in the gastric mucosa may herald an early neoplastic growth at the luminal aspect in some of the cysts.