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CASES OF EARLY GASTRIC CANCER PROVED BY BIOPSY BUT WAS CONSIDERED AS OF BENIGN NATURE BY X-RAY AND ENDOSCOPY Sotaro Fukuchi 1 1Dept. of Gastroenterology, Toranomon Hospital pp.971-981
Published Date 1969/8/25
DOI https://doi.org/10.11477/mf.1403111086
  • Abstract
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 Of 74 cases of early gastric cancer, 70 cases or 94 per cent were accurately diagnosed by FGS biopsy, while the positive rate of endoscopic diagnosis prior to biopsy was no more than 69 per cent. That of diagnosis by re-endoscopy increased, however, to 91 per cent. This fact accounts for the decrease of typical cases of Ⅱc, Ⅱc+Ⅲ, and instead for rapid increase of shallow Ⅱc type lesions, which are of indefinite demarcation and found around ulcers. They are to be diagnosed accurately only by biopsy. As exact diagnosis on the macroscopic level is difficult for such early gastric cancer as Ⅲ, Ⅱb and I type in which cancer tissue is localized in a part of polyp, biopsy is always necessary for such lesions.

 Two cases of type Ⅲ and one case each of Ⅱb+Ⅲ and Ⅱb+Ⅱc were correctly diagnosed by biopsy. FGS biopsy is most effective in the differential diagnosis of protruded lesions, especially in plateau-like protrusions between Ⅱa type early gastric cancer and Ⅱa subtype formed by proliferation of atypical epithelia, and in the diagnosis of shallow Ⅱc type lesion found around ulcer. The fact that Ⅱc lesion is apt to ulcerate and that its ulcer heals easily has gradually been clarified of late, but ulcer in such a cancer lesion is hard to be discriminated from benign ulcer by endoscopy alone.

 Ⅱc in the surrounding area is often overlooked at a certain time in the course of its natural development. Careful observation of healing process of an ulcer lesion is on that account a must and, if doubtful, it must be subjected without fail to biopsy. It goes without saying that for the diagnosis of early gastric cancer, FGS biopsy is one of the most effective weapons, but its merits cannot be fully proved unless other basic diagnostic technics such as x-ray and endoscopy are sufficiently employed as well.


Copyright © 1969, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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