Abstract
The endoscopic features of gastric adenomas were studied in 55 patients (69 lesions) whose diagnosis was confirmed by means of gastrectomy or polypectomy. Of the 55 gastric adenoma patients, the coexistence of gastric adenocarcinoma was observed in 13 cases (23.6%) and adenocarcinoma in adenoma (focal cancer) was seen in 9 cases (9 out of 69 lesions, 13.0%). To examine the endoscopic features of gastric adenomas, the cases were divided into the following three groups : cases of adenoma without coexistent adenocarcinoma, cases of adenoma with coexistent adenocarcinoma at a different site, and cases of focal cancer. No difference in location, shape, and color of the lesions could be demonstrated among the three groups. The larger the lesion size, the more frequent were the focal cancers, but focal cancers could be found in lesions smaller than 9 mm in size. It is therefore difficult to predict the existence of focal cancer only through endoscopical findings and' furthermore, the diagnosis of focal cancer cannot be made by endoscopic biopsy. It is considered that polypectomy or strip biopsy of the lesion is necessary for the definite diagnosis of adenoma. On the other hand, multiple adenomas were observed in 9 patients, of whom the coexistence of gastric adenocarcinoma was seen in 4 patients (44.4%) and focal cancer was observed in 3 patients (33.3%). As patients with multiple adenomas are assumed closely related to gastric adenocarcinoma, attention should be paid to their management.
