Diagnosis of gastric malignancy by fibreoptic endoscopy and gastric biopsy: Comparison with radiology.

Of 473 patients examined with the fibregastroscope, 27 were found to have evidence of gastric malignant disease on the endoscopic and biopsy results. Of these 27 patients, 20 were initially examined by barium-meal (single-contrast) radiography then by endoscopy and biopsy. The barium-meal study was reported as showing definite malignant disease in two cases (10%), appearances suggestive of malignant disease in 11 cases (55%), and other lesions in eight cases (35%). Endoscopic examination enabled a diagnosis of advanced gastric cancer to be made in 13 cases (65%), of appearances suggestive of malignant disease in two cases (10%), and of other lesions in five cases (25%). Gastric biopsies gave a histological diagnosis of gastric malignant disease in 19 cases (95%), and of appearances suggestive of malignant disease in one case (5%). Furthermore, the histological types of gastric malignant disease were shown by the gastric biopsies. In seven cases without initial screening by barium-meal radiography, endoscopy and biopsy confirmed the diagnosis of gastric cancer in all. It is concluded that endoscopy is superior to radiology in the diagnosis of gastric malignant disease. The study also shows that gastric biopsy further increases the diagnostic ability of endoscopy and should be done in all cases in which gastroscopy is performed.