Failure to Detect Gastric at the Initial Examination and Measures aginst It Tsuneyoshi Yao 1 1Department of Internal Medicine, Fukuoka University Chikushi Hospital pp.27-37
Published Date 1990/1/25
DOI https://doi.org/10.11477/mf.1403110277
  • Abstract
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 Six hundred and fourteen lesions of gastric cancer were reviewd regarding their diagnostic process. Three hundred and sixty-six lesions were detected by routine examination and the remaining lesions by either referral or mass screening.

 Among the cases in which roentgenologic examination was done prior to enodoscopy were divided into the two groups: group A consistes of patients whose gastric cancer was not detected, and control group C, gastric cancer was pointed out on roentgenologic examination. In the same way, subject cases in whom endoscopic examination was done prior to roentgenologic examination were divided into two groups: a in which cancer was not detected, and control group b in which cancer was detected on endoscopy.

 Compared with control groups, the proportions of early cancer, multiple cancers, and small cancer with diameter less than 20 mm were high in both group A and a. Area C was more frequently involved in Group A than in control group, which was statistically significant. Failure to detect gastric cancer occurred in 10.2% of the cases in which roentgenologic examination was done first, and that rate was 19.0% when limited to early cancer. Among the cases in which endoscopy was done first, the rate of cancer detection failure only 0.8% (1 case). Retrospective review covering immediate past 2 years, however, "past detection failure" occurred in 15 cases among roentgenologic examination-initiated group and 19 cases among endoscopy-initiated group. Given the fact that final diagnosis of gastric cancer was made by endoscopy with biopsy, it was suggested that rate of cancer detection failure of endoscopy is equivalent to that of roentgenologic examination. Proportions of multiple lesions and minute cancer as well as distribution of sites of cancer lesions in group C were not different from those in whom panendoscopy detected gastric cancer.

 Based on these findings, i.e., no difference in the rate of failure to detect gastric cancer between roentgenologic examination and endoscopy, we are encouraged to perform roentgenologic examination with confidence, making an effort to enhance the quality of the examination.

Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.


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