A study on the diagnosis of carcinoma of the stomach in Koreans (I)

Chin, S I

Abstract

A study on the diagnosis of carcioma of the stomach was carried out in 105 selected Korean cases ofhistologically proved carinoma of the stomach, aimed to the position and value of roentgenography and gastroscopy.The results were summerized as follows; 1) In the diagnosis of 105 cases of Korean gastric carcinomas, a correctdiagnosis was made by roentgenography in 79.1% and by gastroscopy in 86.7% of all cases. Roentgenography plusgastroscopy permitted a correct diagnosis in 92.3% of all cases. There is no significant difference statisticallyon the diagnostic accuracy between roentgenography and gastroscopy( by t-tst, t=0.8572). 2) In the diagnosis ofcarcinoma of the stomach, with roentgenography the greatest diagnostic error occured in primary ulcerative lesionsand with gastroscopy in inadequate examinations which were resulted from mechenical failures. It occured also inmixed type of infiltration and ulceration for the gross pathology and in lesions of gastric body and pyloricantrum as the site of the lesion. 3) In this series of 105 cases of Korean gastric carcinomas, two cases of earlygastric carcinoma(type IIc+III) were correctly diagnosed by roentgenography and gastroscopy. 4) In this series,the most frequent type of gross pathology appeared to be Borrmann type III, the type of ulceration with spreadinginfiltration, which was 72.4% of all 105 cases and the site of the lesion revealed the highest frequency in thepylorus in 53.3%, but both of these had little significance in the determination of diagnostic accuracy ofroentgenography and/or gastroscopy in gastric carcinomas. 5) The onset of symptoms, clinical manifestations, andphysical findings were reveiwed in all 105 cases of this series. The predominant symptoms were epigastric pain(75.2%), indigestion (73.3%) and weight loss (57.0%) in the order and the most frequent physical fidings wasepigastric tenderness (68.6%). The epigastric mass was palpated no more than 31.3% of all cases. 6) For the earlydetection of gastric carcinoma, the roentgenography must be chosen as first routine examination and thegastroscopy as second adjunctive method, because these two diagnostic procedures show no significant statisticdifference on the diagnostic accuracy one another but the roentgenograhy has some advantages; its ease ofperformance, rapidity, greater safety, fewer contraindications to its use, its ease of re-examination, and fewercharge to the patient.