Iishi H, Tatsuta M, Okuda S
Department of Gastrointestinal Oncology, Center for Adult Diseases, Osaka.
Endoscopy. 1988 Mar;20(2):78-82. doi: 10.1055/s-2007-1018137.
The clinicopathological features of simultaneous multiple gastric cancers, and the accuracy of their diagnosis by routine endoscopic examination were analyzed. In addition, the accuracies of diagnosis of coexisting early gastric cancers by routine endoscopic examination and by the endoscopic Congo red--methylene blue test developed in our hospital were compared. The results showed that multiple cancers occurred frequently in elderly male patients, in patients with early gastric cancer of the flat and elevated types and the depressed type without converging folds, and in patients with advanced cancer of Borrmann type I. These patients frequently have early cancers of the flat or depressed types without converging folds, and advanced cancers of Borrmann type I. The coexisting lesions are very difficult to diagnose by routine endoscopic examination: a correct diagnosis of coexisting early cancers was made in only 28.3% of the cases by routine endoscopic examination. But with the Congo red--methylene blue test, the diagnostic rate was raised significantly to 88.9%. In this test, Congo red and methylene blue are sprayed on the surface of the stomach and are bleached within 2 to 5 minutes on the surface of a tumor, but not on the surface of unaffected mucosa.
分析了同时性多原发性胃癌的临床病理特征以及常规内镜检查对其诊断的准确性。此外，比较了常规内镜检查与本院开发的内镜刚果红-亚甲蓝试验对并存早期胃癌的诊断准确性。结果显示，多原发性癌常见于老年男性患者、平坦型和隆起型早期胃癌以及无集中皱襞的凹陷型早期胃癌患者、Borrmann I型进展期癌患者。这些患者常伴有无集中皱襞的平坦型或凹陷型早期癌以及Borrmann I型进展期癌。并存病变通过常规内镜检查很难诊断：常规内镜检查对并存早期癌的正确诊断率仅为28.3%。但采用刚果红-亚甲蓝试验后，诊断率显著提高至88.9%。在该试验中，将刚果红和亚甲蓝喷洒在胃表面，在肿瘤表面2至5分钟内会褪色，而在未受影响的黏膜表面则不会。
