Radical Endoscopic Resection of Early Gastric Carcinoma: Major Problems Concerning Pathologic Evaluation Touichiro Takizawa 1 1Department of Pathology, Tokyo Metropolitan Komagome Hospital Keyword: strip biopsy , 実体顕微鏡観察 , sm癌 , リンパ節転移 pp.389-396
Published Date 1991/4/25
DOI https://doi.org/10.11477/mf.1403102508
  • Abstract
  • Look Inside
  • Cited by

 There are two major problems in pathologically examining the material of endoscopically resected early gastric carcinoma; whether or not completely resected, and thorough examination for submucosal invasion. In the present study, gastric carcinoma is divided into two groups;well differentiated and poorly differentiated adenocarcinoma. The materials belonging to each group are discussed and evaluated separately.


 1) To examine endoscopically resected material, it is indispensable to make adequate microscopic preparations from the material by means of careful stereoscopic examination.

 2) In case of well differentiated adenocarcinoma, absence of carcinoma at the margin is sufficient to judge the material completely resected.

 3) In case of poorly differentiated adenocarcinoma, the criterion for well differentiated adenocarcinoma does not hold. In our opinion, there should be at least O.5 cm between the margin and carcinoma to judge the material completely resected.

 4) In case of incomplete resection of well differentiated adenocarcinoma, endoscopic resection may well be repeated. However, in case of poorly differentiated adenocarcinoma, repeat endoscopic treatment is prohibited and surgical resection should be performed with lymph node dissection.

 5) When pathologic examination reveals submucosal invasion of carcinoma, surgical treatment is required as radical therapy of gastric carcinoma.

 6) Indication of endoscopic resection should be limited to small mucosal cancer without ulcer or ulcer scar, well differentiated adenocarcinoma less than 2 cm and poorly differentiated adenocarcinoma less than 1 cm in diameter.

 7) Endoscopic piecemeal resection of gastric cancer is contraindicated for radical treatment.

 In conclusion, making adequate microscopic preparations by means of careful stereoscopic examination is prerequisite for accurate evaluation of endoscopically resected early gastric carcinoma.

Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.


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