<s>[INST] context: Gastric Carcinoma is classified on the basis of →
1) Depth of invasion
2) Growth pattern     
3) Histologic subtype

The depth of invasion -

The morphological feature having the greatest impact on clinical outcome ( prognosis) is the depth of invasion.
On the basis of the depth of invasion, stomach cancers are divided into -

A. Early gastric carcinoma (superficial spreading type)

Lesions are confined to the mucosa and submucosa regardless of the presence or absence of perigastric lymph node metastasis.
Has the best prognosis.

B. Advanced gastric carcinoma

A neoplasm that has extended below the submucosa into the muscular wall and spread more widely.​

Growth pattern -

Based on a growth pattern, gastric carcinoma is divided into:-


Exophytic →  Protrusion of tumor mass into the lumen
Flat or depressed  → There is no obvious tumor mass within the mucosa
Excavated (ulcerative)  → Erosive crater is present in the wall of the stomach .


All the three types may be evident at early or advanced stage --> If evident at an advanced stage, prognosis is poor, and if evident at early stage prognosis is good.
An uncommon fourth type of growth pattern is:-

D. Linitis plastica ( Scirrhous Ca) → Abroad region of the gastric wall or entire stomach is extensively infiltrated by malignancy, creating a rigid, thicked leather bottle stomach. It has the worst prognosis.
Histologic subtypes -

The two most important histologic subtypes are

A. Intestinal type → Composed of neoplastic intestinal glands resmbling those of colonic adenocarcinoma.
B. Diffuse variant → Composed of gastric type of mucous cells, which generally do not form glands. The appearance of the cells is "Signet ring" appearance because the mucin in the cell pushes the nucleus to the periphery. It is seen more frequently with E-Cadherin mutation. [/INST] question: The best prognosis in carcinoma stomach is with - | options: A: Superficial spreading type B: Ulcerative type C: Linitis plastica type D: Polypoidal type | answer: A </s>