Endoscopic studies on the superficial spreading type of early gastric cancer.

Twenty eight cases out of 230 cases of early gastric cancer showed the superficial spreading type of early gastric cancer. Seventeen stomachs (60.7%) were compatible to the endoscopic finding of spreading cancerous regions, even to macroscopic and microscopic ones. Other 11 cases were not corresponded clinicopathologically to the infiltrated lesions. These 11 cases were studied on the superficial spreading lesions respectively. They were divided into three groups and compared each other micro- and macro-scopically and endoscopically. Group I contained 6 cases, compatible to micro- and macro-scopic findings but not to endoscopic ones. Endoscopic overdiagnosis may be redness and overflow of white fur and underestimate by a few cancer cells superficially in the mucosae, slight difference in height at the margin of II c and cancer without exposure. Group II was similar microscopic and endoscopic findings but not compatible macroscopically. Both cases in group II were overestimated macroscopically at the infiltrated edge because of color change in mucosae but endoscopically diagnosed by changes of color and gastric area. Group III contained 3 cases of microscopic characteristics and not compatible to macroscopic and endoscopic ones. Endoscopic underdiagnosis may be based on a few cancer cells superficially in normal mucosae and on less depressed lesions. These clinicopathological studies might be worthy to clarify the endoscopic and pathologic discrepancies of infiltrating areas by early gastric cancer, and might improve endoscopic techniques of the gastric mucosal observation.