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Endoscopic Detection of Superficial Depressed Type Early Gastric Cancer at the Cardia Kunio Takagi 1 1Department of Surgery, Cancer Institute Hospital pp.13-22
Published Date 1989/1/25
DOI https://doi.org/10.11477/mf.1403106362
  • Abstract
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 Diagnosis of superficial depressed early gastric cancer at the Cardia has been difficult with only a few reports on small Ⅱc type cancer near the esophagogastric junction (EGJ).

 We experienced only four cases (5.6%) of Ⅱc cancer within 2 cm from the EGJ (cardiac Ⅱc) among 111 cases of depressed early cancer in the upper part of the stomach resected in the past ten years (1978-1987) at the Surgical Department, Cancer Institute Hospital.

 Two of these four cases were solitary lesions. In the other two cases, cardiac Ⅱc type lesions were coincidentally detected during pre-operative examination for Ⅱc type lesion in the lower part of the stomach.

 Macroscopically, Ⅱc type lesions in these four cases extended targentially to the lesser curvature with longer anteroposterior diameter than that along the lesser curvature. Histologically, all cases were well differentiated adenocarcinoma with no ulcer formation. Clues for case finding included Ⅱc + Ⅱa with sm invasion detected radiographically in one case and erosion with redness just below the Cardia detected endoscopically in three cases. In the latex three cases, J-turn observation with forward-viewing gastroscope, reverse film (by GTF) observation, and down observation with sideviewing gastroscope were the procedures leading us to the definitive diagnosis, respectively.

 Thus, from the endoscopical viewpoint, erosive lesion with redness just below the Cardia should always prompt us to entertain the possibility of depressed early cancer in this area.


Copyright © 1989, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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