Eighty-four gastric cancers in patients who had previously been subjected to gastric surgery for benign conditions were histologically classified according to Lauren's method and compared to gastric cancers in patients with no previous gastric surgery. Apart from the absence of sarcomas among the patients previously operated on, there was little difference in the distribution of histologic types among patients previously operated on and not operated on. However, in males previously operated on, the proportion of intestinaltype tumors did not show the expected increase with age. Nor did we observe the increase in intestinal-to-diffuse ratio that might have been expected from the location of the tumors and from the association between duodenal ulcer and blood groups and between blood groups and tumor histology. I t is concluded that intestinal and diffuse types of gastric carcinoma both increase in frequency after gastric surgery, but the increase appears to be larger for the diffuse type. Intestinal metaplasia and gastritis were no more prominent in sections from the primary resectates from 16 patients who later developed gastric cancer than in controls. Infiltration of leukocytes was more prominent in carcinomas found in postoperative patients than in carcinomas found in patients not previously operated on.
Y HISTOLOGY, GASTRIC CARCINOMA CAN BE
B separated into two main entities with different epidemiologic patterns. Following the classification suggested by Laudn6 and slightly modified by Muiioz et al.,9 about 85% of all gastric carcinomas can be classified as of either intestinal or diffuse type. High risk of gastric carcinoma and a high proportion of intestinal type tumors have been associated when analyzed by sex and age16,9J2J6 time trends,7~8 geographic areas and migrant groups,4.S-10 and relation to intestinal metaplasia of the non-tumorous mucosa.4+6 From these observations, it has been suggested that intestinal and diffuse types of gastric carcinoma may be two different etiologic entities, the intestinal type presumably being more dependent upon environmental factors and