Multiple primary cancer means that more that two cancers occur independently in an individual. Recently, the incidence of multiple primary cancer has increased with lengthened survival, of cancer patients, development of new diagnostic technique and increased clinical evaluation. We report a patient who had adenocarcinoma of stomach combined with squamous cell carcinoma of esophagus simultaneously.

Estrogen receptor-related protein was examined on gastrectomy specime from 16 cases of advaced gastric adenocarcinoma and 7 cases of early gastric carcinoma(EGC) by using peroxidase-anti-peroxidase method on formalin-fixed paraffin-embedded sections. Positive reaction was seen in 7 out of 16 cases of advanced carcinoma and in 4 out of 8 cases of EGC(50%). Among advanced carcinoma, 3 cases of mucinous carcinoma were negative and 2 cases of signet ring cell carcinoma(SRC) showed focal positive reaction only in combined poorly differentiated(PD) area(10% of tumor cells). PD advanced carcinoma consisted of 4 cases of medullary type and 3 cases of individual cell type. Two out of 4 medullary type showed positive reaction in 20 and 80% of tumor cells and 2 out of 3 individual cell type showed positive reaction in 50 and 70% of tumor cells. Gland-forming type of advanced carcinoma consisted of 1 each case of intestinal and cardiac type and 1 mixed intestinal and cardiac type. Only 1 case of intestinal type showed positive reaction in 50% of tumor cells Among EGC, 2 cases of SRC were negative and 2 cases of PD carcinoma showed 5 and 10% positivity in PD area and 20 and 40% positivity in admixed gland-forming area. Gland-forming EGC consisted of 3 cased of intestinal type and 1 case of cardiac type. One case from each group showed positive reaction in 50 and 20% of tumor cells, respectively. In summary, positive reaction to antibody to estrogen receptor-related protein(P29) was expressed in PD(66.7%), gland-forming(50%), SRC, and mucinous type in order in both early and advanced carcinoma. The difference between age, sex, and other factors was not clear due to limitation of specimen.

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