GOBLET CELL CARCINOIDS OF THE APPENDIX - A STATISTICAL EVALUATION OF THE BIOLOGICAL BEHAVIORS IN 170 CASES COLLECTED FROM THE LITERATURE AS COMPARED TO 456 ORDINARY TYPE APPENDICEAL CARCINOIDS

A total of 631 cases of appendiceal carcinoids reported in the literature were collected mainly from the United States, Europe and Japan, and 626 cases consisting of 170 goblet cell varieties (Group A) and 456 conventional type carcinoids (Group B) were selected for a statistical comparison from the standpoint of their clinicopathological features and biological behaviors in relation to their histologic characteristics. A statistically significant difference (p < 0.01) between these two groups was found in the male/female ratio and age-distribution, the incidence and sites of metastases and the invasive nature to the mesoappendix. The concept, definition and criteria of mucus-producing carcinoids of the appendix were also reevaluated, and an attempt to elucidate the categorization of goblet cell carcinoids was undertaken. Assuming that a large number of conventional type carcinoids have been known to produce mucous substance at a varying degree, mucus-producing carcinoids were defined as gut-endocrinomas exhibiting a significant amount of mucus-production with characteristics amid those of a conventional carcinoid and an ordinary adenocarcinoma. An additional reevaluation was attempted on the related nomenclature with an identical entity of these neoplasms. Goblet cell carcinoids were considered to be an atypical variety of carcinoids belonging to a type of composite gut-endocrinomas. They may play an important role as one of the ideal tools to clarify the mechanism of histogenesis of gut-endocrinomas and ordinary carcinomas.