The Endoscopie Findings of Superficial Flat Type Early Gastric Cancer (EGC IIb)

Choi, Kyoo Wan; Kim, Yong Il; Yoon, Yong Bum; Song, In Sung; Kim, Chung Yong; Jung, Hyun Chae; Kim, Yong Tae; Lee, Dong Ho; Jang, Yoo Hyun; Kim, Tae Hun; Sheen, Gun Seong; Cho, Chang Rak; Kim, Seon Mie; Han, Chul Ju

Abstract

Early gastric cancer(EGC) has been proved to be a malignant tumor with favorable prognosis in contrast to the advanced one, thus early diagnosis has always been the emphasis regardless its type. In particular, diagnosis of superficial flat type EGC(IIb) is extremely difficult on gross inspection. The aim of this study is to review the clinical features of the patients with EGC type IIb, with special reference to the endoscopic appearance of tumor. We reviewed the medical records and endoscopic findings of 13 patients which were thereafter surgically resected and pathologically proven EGC type IIb at SNUH from 1989 to 1993. The depressed lesion was observed most frequently in EGC type IIb. The endoscopic suggestion of EGC type IIb were given initially with mucosal bleeding and discoloration. In 3 cases (20%), tumor extended to the submucosa and in only 1 case, lymph node metastasis was found. Four patients(30.9%) had another coincidental EGC or peptic ulcer. Every possible effort is needed not to omit the resectable cancer when the mucosal bleeding and discoloration is observed. Careful observation is recommended not to overlook coincidental lesions.