良性様内視鏡所見を呈した生検陽性例

POSITIVE GASTRIC BIOPSY IN CASES SHOWING BENIGN ENDOSCOPIC APPEARANCES

　内視鏡的に良性と考えられていながら生検で癌と判明した例を中心に，やや自由な検討を試みてみた．

　The results of 918 biopsies under guidance of endoscopy have been investigated. Of 315 cases which underwent biopsy with a tentative diagnosis of benign or probably benign ulcer, 16 cancer positive cases were experienced, later proved to be as such by surgery. Cancer was not positive among 127 cases diagnosed as of benign polyps as well as in 77 cases of erosion or gastritis. One positive case in 32 of submucosal tumors proved to harbor a gastric metastasis of lung cancer.

　In 31.6% of cases confirmed by endoscopy as of carcinoma of a depressed type or its suspect and in 45.3 of that of an elevated type, biopsy was negative. Malignancy has been unduly taken into account in these endoscopic examinations.

　The gastrocamera photographs are re-investigated in 12 out of 16 positive cases which showed benign endoscopic appearances. In 7 cases findings which suggest malignancy were overlooked. In one case there were no suggestive findings at the time of biopsy, but unquestionable signs of carcinoma had been photographed several weeks previously. In 4 cases, however, no malignant appearances could be detected even by retrospective survey of films which were taken in following their courses.

　Four representative cases are demonstrated and the importance of biopsy is discussed.