抄録
A gastric adenoma had been called in many terms. In 1977, WHO settled "Histological Typing of Gastric and Oesophageal Tumours". Almost all borderline lesions were included into the WHO's gastric adenoma. We have called clinically a lesion, from which Group III result was obtained by biopsy as "Group III lesion". According to our pathological study, when an adenomatous tissue composed from a papillary tissue, co-existing ratio of carcinoma was so high, as 60.0%. An Group III lesion has arrived at 722 lesions in our hospital, until 1990. The malignant ratio after resection in these Group III lesions was the highest, 17% in polypoid type and increased with the size of the lesion, as 33% in more than 2cm, and had closed relationship to the color of the surface of the lesion. After resection of these Group III lesions, focal carcinoma in adenoma was detected 9%. False negative ratio of initial biopsy for these Group III lesions was 9% in focal carcinoma in adenoma, and extremely high 22% in the group with papillary tis-sue. Group III lesions resected after more than twice biopsy were 56 lesions with surgical resection and 19 lesions with endoscopic resection. Detection rate of cancer was increased with follow up period. In 26 Group III lesions followed more than one year and confirmed their histology after resection, $ lesions of carcinoma. Out of them, six enlarged lesions during follow up study were all carcinoma. A carcinoma was detected in all three lesions, in which their sur-faces changed from granular to nodular. Even if high risk findings are not recognized, there may be co-existence of carcinoma. Therefore, endoscopic resec tion of polypectomy or strip biopsy for an Group III lesion is recommended, in the meaning of histological examination of whole the lesion.
