Diagnostics of small gastric carcinoma.

We studied the diagnostic features of 32 early gastric carcinomas less than or equal to 1 cm in maximum diameter, which were detected in 28 patients. A correct preoperative qualitative diagnosis was made in 19% of the lesions by means of barium studies, in 72% by endoscopy, and in 90% by endoscopic biopsy. Endoscopy and endoscopic biopsies are the most useful diagnostics for detection of these small cancers. Since most carcinomas with a diameter between 6 and 10 mm have a mucosal unevenness such as a shallow depression with an irregular perimeter and are associated with or without elevated marginal mucosa on gross inspection, it was not very difficult to detect these carcinomas with careful endoscopic observations. When endoscopists procure such evidence, biopsies should be done for confirmation. Even in ulcers that appear benign, biopsies are recommended. With regard to carcinomas of less than or equal to 5 mm in diameter, it is difficult to detect the lesions, particularly the flat-type, which make up a relatively large percentage of those minute carcinomas.