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Endoscopic ultrasonographic determination of the depth of cancerous invasion in the depressed type of early gastric cancer with special reference to differentiation between cases with and without ulceration



Endoscopic ultrasonographic determination of the depth of cancerous invasion in the depressed type of early gastric cancer with special reference to differentiation between cases with and without ulceration



Gastroenterological Endoscopy 28(12): 3064-3072



Endoscopic ultrasonographic determination of the depth of cancerous invasion in the depressed types of early gastric cancer was studied in comparison to the histological structure of the operative specimen and the endoscopic ultrasonogram of the healing stage of benign gastric ulcer. Several changes in ultrasonogramic patterns due to complication of ulceration were observed in each gastric layer, especially in the third layer, even when the cancerous invasion was limited to the mucosal layer. The non-specific changes in each gastric layer caused by ulceration were as follows. Indistinct narrowing of the second layer, a fine high echo network in the part of low echo of the third layer, irregular interruption of the high echo of the third layer, and wall thickening of the forth layer mainly in the center of ulceration. On the other hand, a decreased echo level of the first layer, a partial defect of the second layer without indistinct narrowing, or a regional stenosis of the third layer were specifically found in the cancerous invasion. By careful endoscopic ultrasonographic examination of each gastric layer according to the above findings, a more accurate diagnosis of the cancerous invasion may be possible.

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Accession: 005359710

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