Pre-operatively Missed Lesions of Multi-focal Early Gastric Cancer Takashi Yao 1 , Masafumi Ohya 1 , Takashi Utsunomiya 1 , Masazumi Tsuneyoshi 1 , Akinori Iwashita 2 1The Second Department of Pathology, Faculty of Medicine, Kyusyu University 2Department of Pathology, Fukuoka University Chikushi Hospital Keyword: 早期胃癌 , 多発癌 , 見逃し病巣 pp.633-642
Published Date 1994/6/25
DOI https://doi.org/10.11477/mf.1403105820
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 We analyzed pathologically evaluated 84 cases of multi-focal early gastric cancer (196 lesions) including 45 cases (58 lesions) of pre-operatively missed lesions. The pathological characteristics of pre-operatively missed and detected lesions were as follows: 1) The missed lesions (12 mm, the average in size) were significantly smaller than the detected ones (28 mm), but there were 10 lesions (17%) which were larger than 20 mm in size, 2) The macroscopic shapes of missed lesions were mainly type Ⅱc (67%) and type Ⅱb (16%) which occupied over 80% of the missed lesions. 3) Based on the CMA classification, the lesions in the lower part (23%) were less likely to be missed than those in the upper (30%) and the middle (34%) parts. The lesions on the greater (11%) and the lesser (25%) curvatures were less likely to be missed than those on the anterior (40%) and the posterior (33%) walls. 4) There was no significant difference in size between the missed and the detected lesions on the following areas: the anterior wall and the lesser curvature in the upper part, on the greater curvature in the middle part, and the posterior wall in the lower part. These results suggest that the lesions in these areas are easy to miss regardless of size. 5) The missed type Ⅱc cancers had less fibrosis (ulcer scaring), and were greater possibility of undifferentiated adenocarcinoma than the detected ones.

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