[The gastric surface carcinoma (early carcinoma)]

Gastric surface carcinoma or early cancer is defined as carcinoma limited to the mucosa or submucosa of the gastric wall. It has an excellent prognosis. Enormous progress in detection and histological diagnosis of early gastric carcinoma has been made with fibre-optic gastroscopy and guided biopsy. Macroscopic types and histological pattern of 18 cases of early cancer are described (16 mucosal and 2 submucosal carcinomas). The endoscopic biopsy allows the diagnosis "carcinoma" in most cases, if 5-6 biopsies are taken for examination. Definite diagnosis warrants throughout histological examination of the resected specimen showing the carcinoma limited to the superficial layers of the stomach wall. In 11 of our 18 cases the surface carcinoma was localised to the antrum and the angulus. The size of the carcinoma was less than 2 cm2 in 7 of 18 cases. 6 of 18 cases showed a multicentric origin. The good prognosis of early gastric cancer as compared to deeper infiltrating carcinomas justifies a more aggressive diagnostic approach. Problems concerned with diagnosis, surgical procedures and tissue preparation for histology are discussed.