Summary
We have re-evaluated over-diagnosed cases which were first diagnosed, pre-operatively, as gastric cancer yet later confirmed as benign lesion (excavated lesion, in particular) in the post-operative histological examination of resected stomachs. We have experienced a total number of 1,358 cases which, being detected through mass survey, were diagnosed as cancer and, consequently, operated upon. On the other hand, 61 benign cases were misdiagnosed as cancer, 28 cases being protruded lesions and 33 cases excavated lesions. Among the misdiagnosed cases of excavated lesions, 27 cases were gastric ulcers or their scars, the remaining 6 cases being gastritis or gastric erosion. In 22 out of 33 cases of misdiagnosis, the wrong diagnosis was made by relying solely upon X-ray and endoscopy. Even after the addition of cytology, there were still 9 cases of misdiagnosis. Since, however, biopsy was introduced, there have been only 2 cases of wrong diagnosis. We may safely say that through these findings the absolute necessity of biopsy for the attainment of an accurate diagnosis of early gastric cancer has been sufficiently attested.
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References
Murakami T: Canceration of gastric ulcer. Stomach and Intestine 11: 561–564, 1976
Hisamichi S, Nozaki K, Kitagawa M, et al: Evaluation of mass screening program for stomach cancer. Tohoku J exp Med 118 (Suppl.): 69–77, 1976
Utsumi K: Scar of the benign ulcer with difficult differentiation from IIc type gastric cancer. Stomach and Intestine 1: 277–278, 1966
Ichikawa H, Yamada T, Horikoshi H, et al: Differential diagnosis between benign and malignant gastric ulcer. Stomach and Intestine 8: 1163–1172, 1973
Kinoshita I, Hirayama K, Kimura N: X-ray diagnosis of gastric ulcer. Surgical Diagnosis and Treatment 14: 131–138, 1972
Kataoka I, Yoshida M, Hakozaki K: Endoscopic diagnosis of gastric ulcer. Surgical Diagnosis and Treatment 14: 139–148, 1972
Asano H, Kodama N, Sasagawa M, et al: A case of small benign lesion on the anterior wall of the corpus mimicing the appearance of IIc. Stomach and Intestine 5: 599–603, 1970
Fujita S, Nishida K: A case of benign gastric ulcer (Ul-II) erroneously diagnosed as early gastric cancer (IIc). Stomach and Intestine 6: 343–348, 1971
Yunoki H, Egi N, Okuhara T, et al: One case of benign ulcer resembled to III+IIc. Stomach and Intestine 3: 999–1002, 1968
Yokoyama Y, Yokoyama H, Nagayo T: On biopsy of excavated gastric lesions—with special reference to differential diagnosis of atypical regenerative and cancerous epithelia—. Stomach and Intestine 9: 9–20, 1974
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Yamagata, S., Oshiba, S., Hisamichi, S. et al. Observations on benign gastric ulcer simulating gastric carcinoma. Gastroenterol Jpn 12, 352–356 (1977). https://doi.org/10.1007/BF02774531
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DOI: https://doi.org/10.1007/BF02774531