Abstract
［Introduction］ Group classification was changed with the revision (14th edition, 2010) of the stomach cancer handling agreement and came to include the thing with the neoplastic change in Group 2 by the new Group classification. The Group classification isn′t used than before in our Hospital. Atypical epithelium (become AE) that′s equivalent to new Group 2 in our hospital are included both neoplastic and inflammatory lesions are included. A biopsy result examined the lesion which was AE.
［Object and method］ the AE that pathological diagnosis intended for done 82 cases (0.4%) in 18,930 cases in 31,615 cases of Gastrointestinal endoscopy in two years to December, 2010 from January, 2009, and examined endoscope views and pathology organization views.
［Result］ After it was diagnosed AE, the reexamination was carried out 1-6 months later. We had 66 cases that biopsy was made at reexamination and were cancer 14 cases (21%) and AE 8 cases (12%) . In addition, the magnifying endoscopy with NBI was carried out in 38/82 cases (46%) , we diagnosed the cancer were 35 cases and the case that a last diagnosis agreed with diagnosis using NBI was 23 cases, and the rate was 60.5%. Gastritis or disappeared lesion on last diagnosis were 39/82 cases (47.6%) , cancer were 35/82 cases (42.7%) . It enforced ESD for cancer and diagnosed 38 cases by a case to strongly doubt a cancer in endoscope views or biopsy. The case that didn′t recognize 31 cancers (differentiated types were 27 cases, undifferentiated mixture types were 4 cases) , tubular adenoma with high grade atypia were 3 cases, tubular adenoma with moderate grade atypia was 1 case, no neoplastic lesion were 3 cases by the pathological diagnosis after ESD.
［Conclusion］ There′s a possibility that the neoplastic lesion was included in Group 2. Thus we came to need reexamination clinically. Cases diagnosed for AE were a cancer and inflammation were by about half. The rate of correct diagnosis of cancer at NBI inspection is as low as 60.5% this time, there were many cases also difficult to diagnose pathological population. Although cancer is suspected on clinical presentation, even in patients who repeatedly AE was considered that the surface is due to hyperplasia.
