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Concept and Cases of Type Ⅲ Early Gastric Cancer T. Yoshii 1 , H. Hiratsuka 2 1Dept. of Pathology, Nihon Medical School 2Hiratsuka Hospital pp.183-187
Published Date 1972/2/25
DOI https://doi.org/10.11477/mf.1403109002
  • Abstract
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 Ⅰ. Concept of type Ⅲ early gastric cancer

 According to the agreement on the macroscopic classification of early gastric cancer as was first presented at the Japan Gastrointestinal Endoscopy Society, the difference between Ⅱc and Ⅲ depended on whether or not the depth of excavation was limited within the mucosal layer. On the other hand, the criteria of type Ⅲ printed in English at the beginning of this magazine show that its distinction is based on whether or not the depth of depression reaches beyond the submucosa. The author, for one, prefers the former criteria. At the same time, the criteria of early gastric cancer should be free from histological terms such as the mucosa or submucosa. Accordingly, type Ⅱc should better be defined as the depressed type that has macroscopically erosive depression; and type Ⅲ, as the depressed type that has ulcerous depression.

 According to the current criteria of type Ⅲ, cancer in it must be localized solely on the margins of depression and its size be almost of microscopic dimensions, so that the type Ⅲ whose depression reaches beyond the submucosal layer is macroscopically very hard to diagnose; in fact, it is hardly possible. Therefore, its criteria should be loosened slightly to make more room for macroscopic diagnosis, embodying all depressed types of early gastric cancer as long as their marginal cancer lesions, even when grossly to be recognized, are such that they do not present and finding either of Ⅱa or Ⅱc. For determination of type Ⅲ attention should be paid principally to its gross findings, but there must also be room for possible alteration of diagnosis depending on the histological investigation.

 Ⅱ. Cases of type Ⅲ early gastic cancer

 Three cases have been demonstrated here. The first is compatible with the type Ⅲ in its most strict definition, its depression reaching beyond the submucosa and its marginal localized cancer having only microscopic dimensions; the second shows the same depth of cancer invasion but its marginal cancer area is slightly larger, a type Ⅲ according to slightly enlarged criteria, and the third also type Ⅲ in a broader sense of its definition.


Copyright © 1972, Igaku-Shoin Ltd. All rights reserved.

基本情報

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

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