The History of Diagnosis of Gastric Lesions in the Past Twenty Years: Mainly in Regard to Gastric Polyps Sotaro Fukuchi 1 1Department of Gastroenterology, Toranomon Hospital pp.145-154
Published Date 1985/2/25
DOI https://doi.org/10.11477/mf.1403109688
  • Abstract
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 That gastric polyp grows into cancer with high rate had once been prominent together with views of a majority regarding gastric polyp as precancerous lesion. Following this, the histological criteria of the diagnosis of cancer was reevaluated in that it was considered necessary to discuss gastric polyp by dividing it into two types, namely, hyperplastic polyp and polyps composed of atypical epithelium of intestinal type. Moreover, pathohistological examination of the resected stomach ran parallel to clinical follow-up study by endoscopy and biopsy as prominent means for studying the cancerous change. As a result, such points have been clarified:

 (1) The rate of cancer of hyperplastic polyp is very low, (2) Ⅱa-subtype of polypoid lesion that we maintain is regarded as adenoma of small intestinal epithelial cell type and is thought to be almost benign, (3) with reference to all kinds of so-called atypical epithelium, lesions under 2 cm in size rarely grow into cancer but there are quite a many cases where lesions over 2 cm in size are associated with cancers remaining within the nest of the lesion.

 As mentioned above, with the division and the elucidation of various kinds of lesions different in the entity clinicopathologically in gastric polyps, the characteristic endoscopic appearances of each lesion have been made clear and which developed the differential diagnosis of gastric polyp. However, we still encounter lesions such as those of well-differentiated adenocarcinoma which are difficult to differentiate from Ⅱa-subtype of polypoid lesion or so-called atypical epithelial cell in endoscopy or histology by biopsy. Thus, careful follow-up study for lesions diagnosed as Group Ⅲ are necessary through comparing the endoscopic findings with histological ones by biopsy.

Copyright © 1985, Igaku-Shoin Ltd. All rights reserved.


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