White R M, Levine M S, Enterline H T, Laufer I
Radiology. 1985 Apr;155(1):25-7. doi: 10.1148/radiology.155.1.3975406.
Early gastric cancer (EGC) is defined as carcinoma in which malignant invasion is limited to the mucosa or submucosa. Records of pathologic examinations from the Hospital of the University of Pennsylvania show that EGC comprised 6% of all gastric carcinomas diagnosed between 1977 and 1983 (7/118 cases) compared with 8.2% of gastric carcinomas diagnosed between 1965 and 1977 (12/147 cases). Double contrast radiographic techniques and fiberoptic endoscopy became widely available at our institution in 1976. Thus, the application of these techniques to symptomatic patients has not improved our ability to diagnose EGC. In contrast, the incidence of EGC in Japan has risen from 5% to 35% with the widespread use of these diagnostic techniques. This discrepancy can be attributed to mass screening of asymptomatic patients in Japan because of the unusually high prevalence of gastric carcinoma in that country. American radiologists and endoscopists should therefore recognize that they are unlikely to experience a significant increase in the detection of EGC as long as these examinations are performed predominantly on symptomatic patients.
早期胃癌（EGC）被定义为恶性浸润仅限于黏膜或黏膜下层的癌症。宾夕法尼亚大学医院的病理检查记录显示，1977年至1983年期间诊断的所有胃癌中，EGC占6%（7/118例），而1965年至1977年期间诊断的胃癌中，EGC占8.2%（12/147例）。双重对比放射造影技术和纤维内镜检查于1976年在我们机构广泛应用。因此，将这些技术应用于有症状的患者并没有提高我们诊断EGC的能力。相比之下，在日本，随着这些诊断技术的广泛应用，EGC的发病率已从5%上升至35%。这种差异可归因于日本对无症状患者进行大规模筛查，因为该国胃癌的患病率异常高。因此，美国的放射科医生和内镜医生应该认识到，只要这些检查主要针对有症状的患者进行，他们不太可能在EGC的检测方面有显著增加。
