Clinical Management to Gastric Flat Elevated Lesion (Adenoma and Carcinoma) Tsutomu Hamada 1 1Department of Gastroenterology, Social Health Insurrance Medical Center Keyword: 胃腺腫 , Ⅱa型早期胃癌 , 生検 , 胃EMR pp.1513-1520
Published Date 1999/11/25
DOI https://doi.org/10.11477/mf.1403102868
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 Usually, we confirm the diagnosis of a gastric mucosal lesion by endoscopy and biopsy specimen. During the period from January,1988 to December,1997,164 flat elevated lesions diagnosed as Group Ⅲ and 117 lesions diagnosed as Group Ⅳ ・ Ⅴ by the biopsy specimen were treated by endoscopical mucosal resection (EMR) in our department. We discussed how to manage flat elevated lesions clinically.

 In the Group Ⅲ lesions,139 lesions (84.8%) were diagnosed as gastric adenoma and 25 lesions (15.2%) were diagnosed as gastric cancer by histological examination of the resected specimens. On the other hand, in the Group Ⅳ ・ Ⅴ lesions,100 lesions (85.5%) were diagnosed as cancer and 17 lesions (14.5%) were diagnosed as adenoma. The rate of difference between the histological diagnoses based on biopsy specimens and those based on resected specimens by EMR had no relation to the size and the location of the lesions. After histological examination of specimens obtained by EMR, the origind diagnoses were changed in about 15% of the cases. Those results suggested that the diagnosis of flat elevated lesions were difficult not only macroscopically but also histologically. Considering this, from a clinical viewpoint, we concluded that,EMR should be performed for lesions which are endoscopically diagnosed as flat elevated lesions, irrespectively of the whether the biopsies indicate they belong to Group Ⅲ, Ⅳ or Ⅴ.

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