Abstract
Endoscopic findings of 147 gastric cancers smaller than 10mm in longest diameter in 133 patients were investigated, and diagnostic accuracy of routine endoscopic examination were compared with endoscopic Congo red-methylene blue test developed in our clinic. A correct preoperative diagnosis of cancers smaller than 10mm in diameter was made in 42.2% of the lesions by routine endoscopic examination, especially in types of ha, IIb, and IIc without converging folds, the diagnostic rate being very low. To make a correct diagnosis of these cancers, it is necessary to observe the entire surface of the gastric mucosa under optimal condition and subsequently obtain biopsy specimens from the target lesions. The endoscopic Congo red-methylene blue test raised the diagnostic rate to 83.8% of cancers smaller than 10mm in diameter. In this test, cancers were seen as areas where the dyes were bleached to white, so that this test is very useful to diagnose such lesions in which visual signs of maligmancy are indistinct or absent.
