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Preoperative X-ray Diagnosis of Gastric Carcinoma, Which is Necessary for the Performance of Endoscopic Submucosal Dissection (ESD) Ryuji Nagahama 1 , Hirotaka Nakashima 1 , Akitoshi Miyamoto 1 , Toshifumi Yoshida 1 , Yasumasa Baba 1 1Foundation for Detection of Early Gastric Carcinoma Keyword: 切開・剥離法 , X線診断 , 深達度診断 , 粘膜内浸潤範囲診断 pp.730-742
Published Date 2005/4/25
DOI https://doi.org/10.11477/mf.1403100106
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 We gave an outline of preoperative X-ray diagnosis of gastric carcinoma, which diagnosis is necessary for the performance of endoscopic submucosal dissection (ESD). Whether the ESD method is adopted or not, fine quality X-ray images of the lesion and its peripheral mucosa, where even the gastric area is shown, are necessary. An X-ray image that accurately represents the lesion plane and the solid mass of the lesion itself is also needed.

 Needless to say consideration of the characteristics of the lesion is most important in deciding the depth of cancer invasion. It is also necessary to consider the following two factors ; 1) the findings due to submucosal or deeper layer invasion (the findings based on causal relationship) and 2) the findings correlated with submucosal or deeper layer invasion as shown by statistic analysis in previous clinicopathologic investigation (the findings based on comparison with statistical data).

 To diagnose the exent of intramucosal invasion of the carcinoma, the pertinent guidelines are usually sufficient. However, before extending the use of the ESD, careful attention is needed to assess the progress of undifferentiated and differentiated IIb type of gastric carcinoma, and of the gastric mucin phenotype after due consideration of their X-ray images.


Copyright © 2005, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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