Abstract
In order to contribute to the preoperative determination of the extent of carcinoma infiltration in the wall of the stomach, endoscopical findings at margins of carcinoma spread was reviewed comparing with macroscopical and histological findings of 27 surgical specimens. Analyzed were 30 lesions of 27 cases with diffuse type carcinoma which had well preservation of superficial covering epithelium, though there were carcinoma infiltration in and below the mucosa. According to the mode of carcinoma invasion in the wall of the stomach, these lesions were divided into following 4 groups; Group 1, carcinoma tissue confined within the mid or deep layer of the mucosa, Group 2, carcinoma invaded from the mucosa into the submucosa or deeper layers, Group 3, carcinoma tissue was not found in the mucosa, but in and below the submucosa, Group 4, carcinoma tissue was found neither in the mucosa nor submucosa, but in the proper muscle coat and/or subserosa. Finely irregular uneven surface was observed endoscopically in the Group 1 and 2. There was no distinct difference between Group 4 and areas without carcinoma invasion. As to the superficial characteristic in the level of an area gastricae, there observed no difference between cancerous and non-cancerous mucosa in the Group 1. Slightly rough elevations and sulcation around elevation were, however, conspicuous in the Group 2 and 3. In the Group 4 enlargement of elevation was recognized but sulcation was not so sharp as in the Group 2 and 3. Redness or patchy redness of surface was seen in 9 of 10 cases in the Group 2. In one third of the Group 1 there observed the same redness as in the Group 2. In the Group 3 and 4 the color of the surface was similar to that of non-carcinomatous area.
