Accuracy of Routine X-ray Examination for Gastric Cancer Detection Tsutomu Hamada 1 1Department of Internel Medicine, School of Medicine Juntendo University pp.961-967
Published Date 1985/9/25
DOI https://doi.org/10.11477/mf.1403109782
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 A routine x-ray examination of the upper gastrointestinal tract was performed in 6,168 patients who visited our department between January,1983 and December,1984. Out of the 6,168 patients,1,006 patients (16.3%) were referred to endoscopy and 81 patients were found to have gastric cancer (1.31%).

 In 73.3% of 60 patients who were diagnosed as having gastric cancer and in 17.6% of 68 patients whose radiologic findings were suggestive of gastric cancer, gastric cancer was discovered endoscopically. On the other hand, endoscopy with biopsy confirmed gastric cancer in 4.8% of 183 patients who were diagnosed as having benign ulcer, in 0.9% of 108 patients who were diagnosed as having ulcer scar and in 3.3% of 121 patients who were diagnosed as having benign polypoid lesion, gastric cancer was also detected endoscopically in 1.0% of 290 patients whose radiologic findings were vague mucosal abnormalities.

 Gastric cancer was detected in 9 patients who were not radiologically considered as having any abnormality in the stomach with a radiological false negative rate of 0.15%.

 Only 5.4% out of 1,604 abnormal findings which were picked up by the routine x-ray examination at the anterior wall of the stomach, but 46.5% and 31.8% out of them picked up at the lesser curvature and at the posterior wall of the stomach. Accuracy of the radiological diagnosis for the abnormalities was 70% or more at the anterior wall and lesser curvature.

 Retrospectively, routine radiological diagnosis was discussed by using 70 cases with 82 lesions of early gastric cancer operated on between January,1980 and December,1984. Except for five microcarcinomas,20.7% out of 82 lesions were overlooked. Causes of errors were as follows, multiplicity (29.4%), careless reading mistake (29.4%) and deformed stomach (7.6%).

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


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