抄録
During a 12-year period from 1965 to 1977, minute carcinoma of the stomach smaller than lcm in size was found in 19 (3.9%) of 484 patients with early gastric carcinoma operated on at the Aichi Cancer Center Hospital. Three asymptomatic patients were suspected to have a small lesion by gastric mass survey x-ray examination. Three asymptomatic and 6 symptomatic patients came to hospital to take a thorough examination of the upper gastrointestinal tract. Three had a follow-up as having a benign disease (gastric polyp or peptic ulcer.). Two patients developed a second lesion during a follow-up of benign diseases. In the remaining two, a second tumor was incidentally found on the resected stomach operated on for early gastric carcinoma. There were 13 symptomatic and 6 asymptomatic patients. The former included 10 with epigastric pain and 3 with epigastric fullness. X-ray diagnosis was correct in only three (16%), probably benign in 9 (47%) and normal in 7(37%). Endoscopic diagnosis was correct in 6 (32%), suspicious of malignancy in 8 (42 %) and benign in 5 (26%). Biopsy could obtain tumor tissues in 15 of 17 patients on a single examination. A repeat biopsy was required in 2 patients to make a positive diagnosis. Regarding the gross type, II c was seen in 10 (53%), II a in 7 (73%) and II a + II c in 2. As mentioned above, x-ray diagnosis was more difficult than endoscopy which could pick up an abnormality in all the patients. It is, therefore, concluded that a combined use of x-ray and endoscopic examination will be necessary to detect a minute lesion of gastric carcinoma and early performance of biopsy will make a definitive diagnosis.
