Problems of Biopsy with Focus on False Negative Cases of Gastric Cancer K. Hayakawa 1 , M. Hashimoto 1 , Y. Yoshida 1 , Y. Yamada 1 , S. Fukuchi 1 , Y. Hoshihara 2 1Department of Gastroenterology, Toranomon Hospital pp.1087-1096
Published Date 1984/10/25
DOI https://doi.org/10.11477/mf.1403109612
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 We examined the diagnostic results of the gastric biopsies in the 20 years from 1964 to 1983 in our hospital, and discussed some problems of gastric biopsies with focus on false negative cases of gastric cancer.

 Total number of biopsies accounted for 16.7% of the total endoscopic examinations for the upper GI tract. Of the total 8,351 lesions biopsied, 733 lesions (8.8%) were of early gastric cancer and 1,384 lesions (16.6%) were of advanced gastric cancer. Among the cases of early gastric cancer, 14 lesions (1.9%) were negative for cancer at the initial biopsy, 22 lesions. (3.0%) were diagnosed as Group Ⅲ lesions, which means the borderline lesions between benignancy and malignancy according to the diagnostic criteria of gastric carcinoma, and the percentage of false negative cases was 4.9%. Of the Group Ⅲ lesions, 91% was of the elevated type lesions, which were difficult to diagnose as cancer based on the histology of biopsy specimens, but the resected specimen proved to be well differentiated adenocarcinoma histologically.

 Of the false negative cases except for Group Ⅲ lesions, early gastric cancer of type Ⅱc was noticed in the highest numbers (9 cases). In the cases of depressed type of undifferentiated adenocarcinoma, the distribution of the cancer cells may be localized inside the lesion, and the cancer cells infiltrated sparsely. There may be possibility for false negative results in such cases and several biopsy specimens must be taken from various portions inside the lesion.

 The false negative rate of advanced gastric cancer was 4.3% at the initial biopsy. Borrmann 4 type had the highest negative rate.

 In order to accurately diagnose gastric cancer by biopsies, it is important to take hold of the macroscopic appearance of the lesion correctly endoscopically and to perform the aimed biopsy exactly. The accurate endoscopical diagnosis eliminates possibilities of false negative diagnosis by biopsy.

Copyright © 1984, Igaku-Shoin Ltd. All rights reserved.


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