| Theme | Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer | |
|---|---|---|
| Title | Indications for Endoscopic Therapy for Gastric Tumors -- Assessment of Endoscopic Findings and Histological Diagnosis Using Biopsy Samples for Extension of Indications | |
| Publish Date | 2001/11 | |
| Author | Tomoki Michida | Department of Gastroenterology, Osaka National Hospital |
| Author | Yoshiya Nishimura | Department of Gastroenterology, Osaka National Hospital |
| Author | Masahiro Ikeda | Department of Gastroenterology, Osaka National Hospital |
| Author | Toshimasa Tsujinaka | Department of Surgery, Osaka National Hospital |
| Author | Kunimitsu Kawahara | Department of Pathology, Osaka National Hospital |
| Author | Akihiko Kurata | Department of Pathology, Osaka National Hospital |
| [ Summary ] | The accuracy of endoscopic and histological diagnosis of gastric tumors, which could be treated endoscopically, was assessed. Among 122 operatively resected specimens of early gastric cancer, 89 tumors (73%) were correctly diagnosed preoperativel in terms of depth and the coincidence rate for endoscopic forceps biopsy examinations was 79%. In 96 endoscopically treated patients, with the Group III lesions, diagnosed by forceps biopsy specimens, 22 lesions(23%) were finally diagnosed as early gastric cancer, 64 lesions as adenoma and 10 lesions were seen to be regenerative atypia. The tumor size was significantly larger in the cancer group than in the adenoma group. The findings for those with a shape indicating I or IIc type and severe atypia in histology were apt to be carcinomial. In 5 out of 7 female patients the lesions were cancerous, without adenomaous elements, which means they had been diagnosed as strictly borderline lesions before endoscopic mucosal resection (EMR). In 108 early gastric cancers resected by using EMR, 7 (6%) and 6 cases (6%) were misdiagnosed histologicaly and in terms of depth respectively, before treatment. These results suggest that comprehensive consideration of the size, shape, depth, and histological examination provides correct diagnosis of gastric tumors before treatment. | |