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Endoscopic diagnosis of depth invasion in depressed type early gastric cancer including comparative study with roentgenography



Endoscopic diagnosis of depth invasion in depressed type early gastric cancer including comparative study with roentgenography



Stomach & Intestine (Tokyo) 22(2): 143-160



Three hundred and eleven lesions of depressed type early gastric cancer and 478 lesions of depressed type advanced gastric cancer were studied to compare preoperative x-ray and endoscopic diagnoses with pathological findings in order to define capabilities and limitations in diagnosing depth invasion of gastric cancer. Furthermore, the cases erroneously diagnosed endoscopically were investigated pathologically to determine the factors contributing to the diagnosis of depth invasion. Endoscopy and x-ray did not differ significantly in proportion of erroneous diagnosis occurring in 8.1% and 8.7%, respectively, as a whole. The same was true when considered separately for early and advanced gastric cancer. Retrospectively, however, it was estimated that about 92% of early gastric cancer and about 96% of advanced cancer can be correctly diagnosed by endoscopy. Almost 25% of advanced cancer erroneously diagnosed as early cancer by endoscopy were diagnosed correctly by x-ray, which suggests a supplementary role of x-ray in this setting. There were cases, however, in which the reverse was true, i.e., depth of invasion was correctly diagnosed only by endoscopy. Extensive fibrosis associated with ulcer formation and cancer invasion deep in sm accounted for 85% of the cases with early cancer erroneously diagnosed as advanced cancer by endoscopy, whereas scattered cancer cells in sm and pm accounted for the most of the cases with advanced cancer erroneously diagnosed as early cancer.

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Accession: 005359172

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