Diagnosis of early gastric cancers in the upper part of the stomach by the endoscopic Congo red-methylene blue test.

The clinicopathological features of the early gastric cancers in the upper part of the stomach, and the accuracy of their diagnosis by routine endoscopic examination were examined, and the accuracy of diagnosis of minute and flat cancers in the upper portion of the stomach by routine endoscopic examination and by the endoscopic Congo red-methylene blue test developed in our clinic were compared. Early cancers in the upper part of the stomach occurred in the elderly patient, and grossly elevated types were frequent. Endoscopically they were most difficult to diagnose by a single routine endoscopic examination, because they were frequently overlooked, and adequate biopsy was difficult in some cases. A correct diagnosis of minute and flat cancers in the upper part of the stomach by routine examination was made in only 27.3% and 25.0% of the cases, respectively. But with the Congo red-methylene blue test the diagnostic rate was raised significantly to 75.0% and 83.3%, respectively. In this test, Congo red and methylene blue sprayed on the surface of the tumor were bleached white 2 to 5 minutes after application, in sharp contrast to the unaffected mucosa.