Endoscopic analysis on the growth of early gastric carcinoma.

Earliest endoscopic appearance and its subsequent changes were studied in 41 cases of early gastric carcinoma where gastrocamera photographs were available for detailed analysis over the period from three months up to 10 years. The earliest appearance of polypoid carcinoma was a small area of nodularity, and that of carcinoma with mucosal depression was patchy reddening. Both types of carcinoma were thought to occur initially as a lesion without mucosal elevation or depression (IIb). In carcinoma with shallow mucosal depression (IIc and IIc-+III), there were cases believed to have remained intramucosal for an extremely long period of several years, whereas, in polypoid carcinoma (IIa and I), the growth seemed to be more rapid. In the cases with ulcer within the carcinomatous lesion, healing of the ulcer was confirmed in 37%, and "malignant cycles" were observed in 21%. Malignant transformation of gastric ulcer was suggested in one case with linear ulcer.