[Clinical and radiological appearance of early gastric cancer in comparision with endoscopical and surgery findings (an analysis of 40 cases) (author's transl)].

Forty cases of so-called early gastric cancer were investigated for their clinical symptomatology and radiological appearance. The essential symptoms are noncharacteristic abdominal pain and weight loss. Polypoid early cancer and depressed types which appear to be benign are problematical for x-ray diagnosis. In occult symptoms like depressed position or breaking off of mucosal folds in the surrounding of an ulcus, malignant growth is thought to occur. The x-ray diagnosis was compared with the gastroscopic diagnosis. The percentage of mucosal carcinomas which were secured preoperatively by biopsy could be increased considerably. In cases of polypoid early cancer the biopsy shows the most negative results. Often the basis of these polyps is cancerously degenerated only partially. Therefore we demand to take more tissue on different places. Especial problematically in x-ray diagnosis is the flat growing form of early gastric cancer if it is situated subcardially. Three of these cases could be neither diagnosed as benign nor as malign. Here the gastroscopy is superior to the x-ray diagnosis. A comparison with the results of surgery shows that half of the cases can be identified as malignant by the microscopical diagnosis only. The laparotomy without opening of the stomach can also lead to misinterpretations. The most important task of the x-ray diagnosis is the early detection of occult changes of gastric mucosa.