胃癌生検偽陰性例の検討

抄録

With the development of fiberoptic instruments, gastric biopsy under direct vision has become a routine diagnostic procedure for the diagnosis of gastric cancer. However, a false negative biopsy is occasionally encountered despite the advances in instrument and biopsy technique. The purpose of this work is to review false negative biopsies in our series of the period from January 1969 to December 1974. A total of 1718 biopsy examinations were performed during the period and a false negative result was obtained in 199 examinations. The 199 included 62 of Borrmann IV type, 47 of Borrmann III type, 37 of cancer of the cardia and 54 of others. The rate was 22.4 percent in recurrent tumor, 22.2 percent in Borrmann IV type, 18.6 percent in cancer of the cardia and 36.8 percent in others. The high false negative rate of biopsy was expected in the former three types, because cancer cells were present mainly in the submucosa. It is surprising that the lesions endoscopically presenting as benign ulcer had a high false negative rate, being 17.8 percent which was high next to cancer of the cardia. The others accounted for less than ten percent. The major causes of false negative biopsy are considered as follows : Submucosal infiltration, 54.3 percent; technical error, 36.7 percent. These two accounted for approximately 90 percent and the other causes were noted in less than three percent.