Schlag P, Merkle P, Wetzel S, Rödl W, Meister H, Herfarth Ch
Dtsch Med Wochenschr. 1978 May 5;103(18):773-7. doi: 10.1055/s-0028-1104508.
Among 947 patients operated on for gastric carcinoma between 1961 and 1976 there were 60 with early (superficial) gastric carcinoma. All but two patients consulted their doctor for diverse complaints. In one third of them treatment was delayed for a year or longer. In 26 of the 64 cancer foci it was limited to the mucosa. The correct diagnosis was made radiologically in 60%, gastroscopically in 70%. Selective endoscopic biopsy increased accuracy to 90%. The remaining false-negative findings occurred in the ulcerative form, which was the most frequent one. Improved radiological techniques (double-contrast) and obligatory gastroscopy with biopsy increased the relative proportion of early (superficial) carcinoma from under 4% in 1961 to 15%. The diagnosis of this type of carcinoma can be made only by careful histological study of the surgical specimens. Here as elsewhere in the surgery of carcinoma, multicentricity (in 5%) and possible lymph node metastases (10-20%) must be taken consideration in the surgical management.
在1961年至1976年间接受胃癌手术的947例患者中，有60例患有早期（浅表性）胃癌。除两名患者外，所有患者均因各种不适症状就医。其中三分之一的患者治疗延迟了一年或更长时间。在64个癌灶中，有26个局限于黏膜层。通过放射学检查正确诊断的比例为60%，通过胃镜检查正确诊断的比例为70%。选择性内镜活检将准确率提高到了90%。其余假阴性结果出现在最常见的溃疡型中。改进的放射学技术（双重对比）和强制性的胃镜活检加病理检查使早期（浅表性）癌的相对比例从1961年的不到4%提高到了15%。这类癌症的诊断只能通过对手术标本进行仔细的组织学研究来做出。在此处以及在其他癌症手术中一样，在手术治疗时必须考虑多中心性（5%）和可能的淋巴结转移（10 - 20%）。
