Abstract
Objective: Hell cobacter pylori (H. pylon) infection causes chronic gastritis, and intestinal metaplasia may lead to gastric cancer. In this study, we investigated whether the gastric cancer screening interval should be considered with respect to the presence or absence of granular lesions (GL), an endoscopic finding of the metaplastic mucosa on screening endoscopy. Methods: The subjects were 63 patients in whom a review of the films confirmed the lesion site 3 times or more among patients who were diagnosed as having gastric cancer between January,1989 and June,2004. We examined the relationship between the presence or absence of GL at the lesion site on the first film on which it was confirmed and the histological/macroscopic type of gastric cancer, and compared the interval until gastric cancer was diagnosed. Results: With respect to the histological type of gastric cancer,57%of differentiated adenocarcinoma patients and 29%of signet ring cell cancer patients had GL. In addition, the differentiated adenocarcinoma patients were examined with respect to the macroscopic type of gastric cancer, and67% of Ha type patients,50% of IIa+IIc type patients,47% of Tic type patients,50% of IIc+III type patients, and 67% of advanced cancer patients had GL. Among the signet ring cell cancer patients,13% of IIc type patients,40%of IIc+III type patients, and 100% of advanced cancer patients had GL, but no Ith type patient had any GL. The mean interval from the first film on which the lesion site was confirmed until diagnosis was 4.5 years. The interval until diagnosis was examined with respect to the histological type and the presence or absence of GL. Among the differentiated adenocarcinoma patients, the interval was 4.5 years in those with GL and 3.6 years in those without GL. Among the signet ring cell cancer patients, the interval was 5.8 years in those with GL and 4.7 years in those without GL. Conclusions: The incidence of GL was higher in the differentiated adenocarcinoma patients. However, there was no marked difference in the interval until gastric cancer was diagnosed between the patients with and those without GL. It may be difficult to consider the endoscopy interval regardless of the histological/macroscopic type.
