抄録
The clinical problems of gastric adenoma are its differentiation from carcinoma and its coexistence with carcinoma. We challenged these problems with a magnifying endscope in the elevated lesions of the stomach including adenoma and IIa-type early gastric carcinoma. The subjects included hyperplastic polyps (15 cases), adenomas (15 cases), ha-type early cancers (7 cases), IIa+IIc-type early cancer (1 case), well-differentiated early cancers of excavated type (17 cases) and Borrmann's type I advanced cancers (4 cases) . The tissue samples taken from these subjects during surgery were also observed with a stereo-microscope to compare the findings with those obtained with the endoscope. The adenoma surfaces showed several different patterns, i.e., dotty, sulciolar, gyrus-like, nodular and mixed pattern. Positive correlation was present between the endoscopic findings and the degree of the histological atypia in adenoma. Namely, the dotty pattern, the sulciolar pattern and the gyrus-like and nodular pattern were frequently associated with mild, moderate, and severe cell atypia. On the other hand, the findings of magnifying endoscopy in the cases of the gastric carcinoma were characterized by the lesions of an irregularly nodular or destructive pattern, which were clearly differentiated from those of adenoma. The above results suggest that the follow up of gastric adenoma with a magnifying endoscopy is as useful as a biopsy.
