内視鏡からみた陥凹型早期胃癌(IIc,IIc+III)の深達度診断

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  • ENDOSCOPIC DEPTH DIAGNOSIS OF DE-PRESSED TYPE OF EARLY GASTRIC CANCER (IIc AND IIc+III).

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Among 140 cases of depressed type of early cancers, 131 were II cs and II c+IIIs, of which II cs were 55 consisting of 28 m and 27 sm lesions, whereas II c+ IIIs were 76-34 m and 42 sm lesions. Data from these cases were reevaluated. No relationship was noted between the depth of invasion and age or sex. In regard to the size of II c, sm group was approximately 3 times as large as m group, whereas in the II c+ III group, sm lesions averaged 1.5 times as large as m group. The so-called “stiffness”, by which we mean poor distensibility or mobility as observed by endoscopy, was more frequently noted in sm group. “Stiffness seems to represent fibrosis and cancer tissue in the submucosa. The characteristic features of the converging folds, namely sudden interruption, irregular thinning, clubbing, and fusion, are not indicative of m or sm. What we call “the clarity grade of II c, by which is meant the percentage of the length of macroscopically identifiable II c border compared with the total length of IIc border-line, was larger in the sm group than in m group. In conclusion, the conventional criteria of depth diagnosis are not very reliable and further study is desired to establish the new criteria.

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