Gastric Inflammatory Diseases which Requie Differential Diagnosis from Superficial Depressed Type Early Gastric Cancer-Endoscopic Differential Diagnosis Yoshihito Uchida 1 , Syuuhei Kamano 2 , Toshiyuki Kagawa 2 , Minako Ito 2 , Hideyuki Inoue 2 1Department of Integrated Medicine, Kagawa Medical University 2Third Department of Internal Medicine, Kagawa Medical University Keyword: 胃びらん , びらん性胃炎 , 孤立性胃粘膜萎縮 , 腸上皮化生 pp.1679-1686
Published Date 2002/12/25
DOI https://doi.org/10.11477/mf.1403104610
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 Endoscopic differential diagnosis of gastric inflammatory diseases, which included erosive gastritis, atrophic gastritis and intestinal metaplasia, and superficial depressed type (Ⅱc type) early gastric cancer was reviewed. In order to make a differential diagnosis of the erosion, it is instructive to observe the erosion from the depressed area to the margin and surrounding area. When even one malignant finding is observed, forceps biopsy is mandatory. In the case of multiple erosions, forceps biopsy is necessary when their size and/or color is clearly different from other erosions, and when their locations deviate from their longitudinal arrangement on the gastric folds. A prospective study was carried out to evaluate the diagnostic accuracy. Of the 746 lesions of which the diagnosis of benign erosion was made endoscopically, 9 lesons (1.2%) yielded the histological diagnosis of Group Ⅴ. On the other hand, of the 39 lesions of which the diagnosis of early gastric cancer was made endoscopically, 3 lesons (7.7%) yielded the histological diagnosis of Group Ⅰ or Ⅱ. In the case of a solitary focal atrophic mucosa located in the fundic gland area, it is necessary to make the differential diagnosis of undifferentiated type cancer. In the cases of widely spreading intestinal metaplasia, the non-metaplastic area may resemble Ⅱc type early cancer, so differential diagnosis is required. The non-metaplastic area of which the size and/or color is clearly different from others should be examined by forceps biopsy.

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