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Gastric Adenomas in High Risk Group for Malignancy; Endoscopic and Clinicopathological Characteristics Shigeaki Yoshida 1 , Masahiko Akiya 1 , Hajime Yamaguchi 1 , Daizo Saito 1 , Teruyuki Hirota 2 1Department of Internal Medicine, National Cancer Center Hospital 2Department of Pathology, National Cancer Center Hospital pp.693-700
Published Date 1987/6/25
DOI https://doi.org/10.11477/mf.1403112914
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 Four hundred and sixty adenomas in 399 cases were identified and well documented photographically by histological examination of biopsy and/or resected specimen at National Cancer Center Hospital during the period between 1962 and 1986. The malignant potentials were examined endoscopically and clinicopathologically in these 460 lesions.

 The results obtained were as follows:

 1) Of the 460, 423 lesions were histologically diagnosed as Group Ⅲ (adenoma) by biopsy. Of the 423, 184 were resected following biopsy with the final histological diagnosis, adenoma in 154, focal carcinoma arising from adenoma in 9, and carcinoma in 21 lesions. The malignant potential in this group, therefore, corresponded to 16% (30/194). On the other hand, of the 460, 217 lesions were resected, and included 176 lesions of adenoma and 20 lesions of focal cancer. Hence, the malignant potential in gastric adenoma resected was estimated as 10% (20/196).

 2) Endoscopic and clinicopathological characteristics of the adenomas with malignant lesions were summarized as follows; polypoid or gastritis-like type, larger than 2 cm in size, reddish surface endoscopically, mixed with depressed component within the lesion such as Ⅱa+Ⅱc or Ⅱc type early cancer macroscopically.

 3) According to multivariate analysis by quantification theory No. 2 by Hayashi, partial coefficiency to malignancy that corresponds to weight of each finding concerning to the malignant potential of adenomatous lesions was highest in the color, followed by the size, the macroscopic type and the combination with depressed component. These items were useful in differentiating malignant from benign cases with statistical signif icance (p<0.01).

 The results stated above suggest that gastric adenomas or Group Ⅲ lesions evidently have the malignant potential and that it is possible to pick up high risk patients for malignancy based on endoscopic findings. When a patient has a Group Ⅲ lesion, for example, showing a reddish, large, marked polypoid or gastritis-like appearance and/or depressed component, short term (within three or six months) follow up by endoscopy and biopsy should be in order.


Copyright © 1987, 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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