Abstract
There were 526 early gastric cancers in 453 patients who underwent gastrectomy at our center from 1982 to 1987. Among them, we studied the clinical findings and endoscopic diagnosis of depressed-type early gastric cancers in the cardia. The results were as follows: 1) There were fourteen lesions in thirteen patients with depressed-type early gastric cancers in the cardia, which was equivalent to 2.7% of early gastric cancers. 2) Macroscopically, only one IIc lesion had an ulcer while most of the other IIc lesions were without ulcers or ulcer scars (Table 6). Histologically, ten cases (71.4%) were well or moderately differentiated adenocarcinomas (Table 7). 3) To detect depressed-type early gastric cancers in the cardia, it is important to perform thorough endoscopic examination and biopsy of lesions with erosive change in the cardia (Table 9, 10). 4) When the lesion is on the lesser curvature or on the posterior wall in the cardia, it is suitable to view the lesion from above using a lateral-viewing fiberscope for en face observation. But when the lesion is on the greater curvature or on the anterior wall in the cardia, it is feasible to apply the U-turn or J-turn method using a front-viewing or oblique-viewing fiberscope (Table 12).
