Between 1968 and 1987 we performed gastrectomy for early carcinomas of the C-area in 83 patients with 86 lesions. These lesions were divided into four groups on the basis of their location : 11 were found less than 1
cm from the esophago-cardiac junction (CA 1 group), 9 in the 1-2
cm region (CA 2 group), 39 in the 2.1-4.0
cm region (NC group), and 27 greater than 4.1
cm away (UB group).
1) The incidence of early cancer in the C-area and the cardia was 86/766 (11.2%) and 20/766 (2.6%). The early-advanced ratio and the ratio of cancer limited to the mucosa in the depressed types were low in the C-area and the cardia. The differentiated -undifferentiated ratio of histological types became higher, and the m-sm ratio of the lesious (11-30
mm in size) became lower, the closer the lesion was to the E-C junction.
2) On routine X-ray examination, 15 of the 18 elevated lesions were detected. However only 39 of the 60 depressed lesions were detected, 3 lesions in the CA 1 group (3 / 9 ; 33.3 %), 6 lesions in the CA 2 group (6 / 6 ; 100%), 12 lesions in the NC group (12/22 ; 54.5 %), and 18 lesions in the UB group (18/23 ; 78.3 %).
None of the lesions without ulcer scars in the CA 1 group were detected by X-ray examination because the cardia was not opened. It was necessary to have large volumes of air in the stomach to diagnose the carcinomas. The lesions located in the anterior wall of the NC or UB groups were also overlooked. The double contrast method of prone position was required for detection.
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