Detailed X-ray Examination of Early Gastric Cancer for Identifying the Extent of Invasion Tozo Hosoi 1 1Tokyo Metropolitan Cancer Detection Center Keyword: 早期胃癌 , 浸潤範囲 , 精密検査 , 内視鏡的粘膜切除術 pp.73-86
Published Date 1993/2/26
DOI https://doi.org/10.11477/mf.1403106088
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 The extent of invasion of early gastric cancer may be crucial for selecting the treatment of choice. We analyzed it from the x-ray diagnostic points of view. For gastric cancer being located in the cardiac region and the upper body, it is very important to diagnose their extent of invasion, especially to the lower esophagus. The useful projections and positions of double contrast study to identify the extent of invasion are the left anterior oblique view of the lying on the right side or the semi-recumbent position, and the frontal or right anterior oblique view of the upright position. For gastric cancers being located in the gastric body, the selection of surgical method, whether a total or partial gastrectomy, is based on the distance between the edge of invasion and the EGJ. This choice would affect the patients' quality of life. Therefore, the diagnosis of the extent of invasion, particularly in oral edge of the lesion in the gastric body is important. Double contrast study in the supine position is useful to determine the invasivty, but that in the upright position is necessary to measure a distance from the EGJ. To evaluate an indication for endoscopic mucosectomy, it is important to diagnose the invasivity to the surrounding mucosa of the undifferentiated type cancer, in particular, with the elevated lesion.

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