J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 3491KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 99(9): 558-563, 1998

Feature topic

ENDOSCOPIC DIAGNOSIS OF EARLY CANCER IN THE ESOPHAGOGASTRIC JUNCTIONAL REGION

Depatment of Endoscopic Diagnosis and Therapy, Tokyo Medical and Dental University School of Medicine, Tokyo, Japan

Kimiya Takeshita, Tatsuyuki Kawano, Naoya Saito, Kagami Nagai, Masao Tani, Tooru Honda, Haruhiro Inoue, ken-ichi Yano, Seitaku Hayashi, Ichiro Saeki, Takehisa Iwai

The endoscopic diagnosis of early esophageai and gastric cancers located within 2cm above and below the esophagogastric junction (EGJ) is discussed. We reviewed 25 cases (10 mucosal cancers and 15 submucosal cancers). Histologically, early cancers frequently appeared as type Ilc lesions (16/25 : 64％). There was no relationship between tumor size and the depth of invasion of cancer lesions, and most of the lesions were well or moderately differentiated carcinomas.
Endoscopically, homogenous redness with a thin white coating, some granular appearance, and easy bleeding were very important factors for the diagnosis of early gastric cancer. For superficial esophageal cancer, differential diagnosis from reflux esophagitis is correctly performed with the endoscopic dye (lugol)- staining method and biopsy. In order not to overlook early cancer at the EGJ, this area should be observed with sufficient air inflation by the U-turn or J-turn method using a frontal-view panendoscope.

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