Endoscopic and histological criteria for preoperative evaluation of the depth of infiltration of gastric carcinoma.

Because the therapeutic approach to gastric carcinoma differs according to the stage of development, a study was carried out to investigate whether there are any factors which would allow the depth of infiltration of a gastric carcinoma to be evaluated preoperatively. The criteria used were endoscopic and histological. The first provide information on size and macroscopic aspect; the second reveal the relationship between bioptic specimens that are positive for carcinoma and those that are negative. On the basis of these standards, small, benign-looking neoplasias with bioptic positivity for carcinoma lower than 30% were classified as probably early. Of the 200 gastric carcinomas investigated, 55 were considered probably early and 145 probably advanced. Surgical fragment findings confirmed the diagnosis in 169 cases (37 true negatives and 132 true positives) and failed to confirm it in the other 31 cases (13 false positives and 18 false negatives). The specificity, sensitivity, negative predictive value, positive predictive value, and total diagnostic accuracy indices were 74.00%, 88.00%, 67.27%, 91.03%, and 84.50%.