Abstract
Resection of early gastric cancers with strip biopsy were performed in 159 cases during the past 5 years (1983-1988) and 1042 cases were surgically resected during the past 13 years (1965-1988). Among them, 20 cases of well differentiated adenocarcinomas showed minute invasion of the submucosal layer. These twenty lesions were classified as 1(5), ha (4), IIa+IIc (3), IIc (6), and IIc+III(3 lesions) on the macroscopic classification of early gastric cancer. Te size of these lesions ranged from 7 to 60 mm in diameter. Consequently, the endoscopic findings of these 20 cases were not thought to be consistent with the macroscpic findings and the size of the lesions. However, the dissecting microscopic investigation of these lesions revealed that a clear depression of the surface of the ha lesions with minute submucosal invasion was related with histological minute submucosal invasion, that type I lesions showed broad erosion on the surface of the lesion and that depressed type cancers like IIc and IIc+III looked a wavy depressive appearance. Concerning the prognosis of the 20 patients with minute submucosal invasive lesions of which follow-up period was five years and eleven month, the fourteen cases without lymph nodes metastasis who had surgical resection, and the seven cases by strip biopsy, 19 patients are still alive as of March 1988. The cause of death of the one remaining case mentioned above was not due to gastric cancer, but was from another cause. According to these results, the prognosis of minute submucosal invasive cases is almost equal to that of intramucosal well and moderately differentiated adenocarcinoma.
