Scirrhous gastric carcinoma: endoscopy versus upper gastrointestinal radiography.
OBJECTIVE
To compare the accuracy of upper gastrointestinal (UGI) series and endoscopic examination in the diagnosis and localization of scirrhous gastric carcinoma.


METHODS
Seventy-two patients with pathologically proved scirrhous gastric carcinoma in surgical specimens were included. Preoperative reports at UGI series and endoscopic examination, which included impressions on the location and extent of the tumor, were compared with pathology reports, and the accuracy of the preoperative reports was calculated. Two gastrointestinal radiologists retrospectively reviewed the appearance of mucosa at UGI series.


RESULTS
Preoperative diagnoses at endoscopy were Borrmann type IV carcinoma in 28 patients (39%), type III carcinoma in 29 (40%), early gastric carcinoma in seven (10%), lymphoma in six (8%), atrophic gastritis in one (3%), and type II carcinoma in one (3%). Preoperative diagnoses at UGI series were type IV carcinoma in 44 patients (61%), type III carcinoma in 25 (35%), lymphoma in two (3%), and early gastric carcinoma in one (1%). Pathology reports were compared with the preoperative reports, and tumor location and extent were correct in the endoscopic examination reports of 24 patients (33%) and the UGI series reports of 49 patients (68%). In 68 patients, UGI series revealed thickened and irregular folds in 62 (91%), ulceration in 42 (62%), and nodularity in 22 (32%) at consensus review. Endoscopic biopsy samples were positive for malignancy in 66 patients (93%).


CONCLUSIONS
UGI series is superior to endoscopic examination in the diagnosis and localization of scirrhous gastric carcinoma.
Park
Mi-Suk
MS
Department of Diagnostic Radiology, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap Dong, Songpa-Ku, Seoul 138-040, South Korea.
Ha
Hyun Kwon
HK
Choi
Byung Se
BS
Kim
Kyoung Won
KW
Myung
Seung-Jae
SJ
Kim
Ah Young
AY
Kim
Tae Kyoung
TK
Kim
Pyo Nyun
PN
Lee
Nam-Ju
NJ
Lee
Jeong Kyung
JK
Lee
Moon-Gyu
MG
Kim
Jin Ho
JH
D002293:Adenocarcinoma, Scirrhous / Q000175:diagnosis* / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D005260:Female; D005773:Gastroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging