Chronological Changes in Gastric Cancers Detected at Our Medical Facility Kazuo Hayakawa 1 1Department of Gastroenterology, Toranomon Hospital Keyword: 胃癌の時代的変遷 , 内視鏡的胃粘膜切除術 , 微小胃癌 pp.39-50
Published Date 1993/1/25
DOI https://doi.org/10.11477/mf.1403105991
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 Since 1964 when gastric biopsy under endoscopic control was first introduced at our hospital, through 1991, endoscopic examinations, surgical resections, and pathological investigations have been completed on 1,407 lesions from 1,270 cases of early gastric cancer, and 1,667 lesions from 1,661 cases of advanced stomach cancer. Added to these data were 79 lesions from 76 cases of early stomach cancer who had undergone endoscopic mucosal resection and chronological follow-up observations to detect recurrences. Annual increases were noted in the incidence of early and advanced stomach cancers that were clinically diagnosed and surgically or endoscopically resected. The percentage increase in early cancer is particularly notable and now comprises more than 60% of total stomach cancers. When the incidence of early cancers is classified according to patient age, the rate has dropped among younger individuals but has increased in the elderly population. When classified according to macroscopic criteria, types Ⅱa, Ⅱc, and Ⅱb showed increases in early stomach cancer, while lesions exhibiting type Ⅲ features were less frequent. Among advanced cancers, the incidence of Borrmann type 4 tended to increase. If classified according to size, there was a marked increase in the incidence of early cancers measuring less than 10 mm. As for the sites occupied by these lesions, the incidence at region C increased while that at region A was lower for the raised type of early stomach cancer. No chronological changes were noted in the incidence of various histological types of early stomach cancer; but among advanced stomach cancers, the incidence of undifferentiated adenocarcinoma has exceeded that of differentiated adenocarcinoma over the past 10 years. The percentage of lesions completely excised by endoscopic mucosal resection was 50.9%, a result which is considered unsatisfactory. At sites such as the middle or upper portion of the gastric corpus, posterior wall, and greater curvature, cancers were often noted to have developed at the gastric stump, indicating a need for innovative application of endoscopic instruments and technological improvements.

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