Endoscopic Diagnosis of Minute Gastric Cancer Kazuo Hayakawa 1 1Department of Gastroenterology, Toranomon Hospital pp.757-773
Published Date 1988/7/25
DOI https://doi.org/10.11477/mf.1403108258
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 Concerning endoscopic diagnosis of minute cancer, endoscopic findings and macroscopic and histological findings of specimens of the resected stomachs were compared. At the same time, we considered findings concerning small cancers.

 Among 64 minute cancer lesions, 27 lesions (42.2%), and among 73 small cancer lesions, 55 lesions (75.3%) were diagnosed before operation by endoscopy and biopsy.

 In specimens of the resected stomachs, 40.7% of the minute cancer lesions that were diagnosed before operation were unconfirmable macroscopically, and totally 59.4% of all minute cancer lesions were unconfirmable.

 The preoperative diagnostic rate of minute cancers less than 3 mm in diameter was 41%. It was 44% for minute cancers of 3-5 mm in diameter.

 It was felt that except for IIb type, careful observation made diagnosis of minute cancers of 3-5 mm possible.

 Almost all cases of the small cancers diagnosed before operation were confirmable by macroscopic inspection of specimens of the resected stomachs. Only 8.2% of total number of small cancer lesions were unconfirmable macroscopically.

 In the case of IIa type minute cancers, the endoscope very often encountered the feature of mild elevation with smooth and whitish surface. However, in the case of small cancers flat semi-spherical shape with irregular convex-concave features and erosion were very often noticed.

 In IIc type minute cancers, elevation with rough, granular convex-concave features around an irregular depression was found to be characteristic of well differentiated adenocarcinoma. Convergence of folds wes absent or, if present, was slight in IIc type minute cancers. In small cancers, irregularities of the edges and elevation around the depression were seen clearly. There was a high frequency of convex-concave features on the surface of the depression.

 Endoscopic findings and macroscopic findings of resected specimens generally corresponded to each other.

Copyright © 1988, Igaku-Shoin Ltd. All rights reserved.


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