Differential Diagnosis of Depth of Invasion in m, sm1 and sm2, sm3 Gastric Cancer-Present Status of Endoscopic Diagnosis Minoru Kawaguchi 1 , Toshihiko Saito 1 , Hironobu Umezawa 1 , Yasuaki Sakai 1 , Manabu Nishimaki 1 1The Fourth Department of Internal Medicine, Tokyo Medical College Keyword: sm胃癌 , 深達度診断 , EMR , 内視鏡診断 pp.1689-1697
Published Date 1997/12/25
DOI https://doi.org/10.11477/mf.1403105261
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 Extensive application of endoscopic mucosal resection (EMR) to some submucosal (sm) cancers has occasionally been reported in the literature. The critical issue in this situation is whether the depth of invasion of such lesions can be determined preoperatively. This paper describes the accuracy of endoscopic diagnosis of the depth invasion of mucosal (m) and sm1-α carcinomas, for which EMR is usually indicated, and sm1-β, sm2 and sm3 carcinomas, for which EMR is not indicated. The accuracy rate of diagnosis of the depth of invasion was about 90% when evaluation was restricted to non-ulcerated lesions measuring 2 cm or less in diameter. In this evaluation, lesions having certain endoscopic features suggestive of sm carcinoma were classified under the category of SM, while other were classified as M. Endoscopic findings and histopathological findings in the resected stomach were also compared in patients who eventually underwent surgery because pathological examination following EMR revealed sm1-β or deeper invasion. It is important to perform surgical resection without missing the opportunity if pathological examination following EMR demonstrates sm1-β or deeper invasion.

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