Evaluation of Invasivity of Early Gastric Cancer by Radiologic, Endoscopic and Ultrasonographic (EUS) Examination Akimichi Chonan 1 , Fukuji Mochizuki 1 1Department of Gastroenterology, Sendai City Medical Center Keyword: 早期胃癌 , 深達度診断 pp.57-71
Published Date 1993/2/26
DOI https://doi.org/10.11477/mf.1403106086
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 To evaluate diagnostic findings of invasivity of early gastric cancer invading further than the submucosal layer, we studied two hundred and twenty cases of early gastric cancer. Our results were as follows:

 1) In the elevated type early gastric cancer, deep depression on the surface of a tumor indicated submucosal invasion, but the size of a lesion did not correlate with invasivity by radiologic examination. Both ulceration on the surface and a submucosal tumor-like mucosal elevation covered with normal mucosa were important findings by endoscopic examination. The destruction of the third layer suggested submucosal infiltration of tumor cells by EUS.

 2) In the depressed type early gastric cancer without ulceration or ulcer scar, radiolucency around a deeply depressed lesion indicated the submucosal invasion by radiologic examination. A surrounding normal mucosal elevation and a white coated depression on endoscopic examination suggested the submucosal invasion. The destruction of the third layer showed the submucosal infiltration by EUS.

 3) In the depressed type early gastric cancer with ulceration or ulcer scar, elevated and fused mucosal folds at the rim of a depression, radiolucency around a depression, and distinct wall rigidity were useful for evaluating invasivity by radiologic examination. Swelling and fusion of the mucosal folds at the rim of a depression, elevation around a depression, plate-like elevation, and rigidity of an entire depressed lesion were important findings suggesting submucosal invasion by endoscopic examination. Both intra- and extraluminal thickening of the gastric wall indicated submucosal infiltration by EUS.

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