[Diagnosis of early gastric cancer measuring 1 cm or less]

Rates of detection roentgenological and endoscopic examinations were investigated in 87 patients with 93 lesions of early gastric cancer measuring 1 cm or less. In the depressed type, the minimum size for detection was 5 mm roentgenologically and 3 mm endoscopically. Depressed lesions with ulcer scars could be detected roentgenologically, but depressed lesions without ulcer scars could not be detected, unless the depressions were more than 0.5 mm and were accompanied by mucosal elevations surrounding the lesions. The detection of undifferentiated cancer without ulcer scars was poor, because mucosal elevations surrounding the lesions were rare in such histological types. In the elevated type, the minimum size detectable roentgenologically was 7 mm in width, 0.9 mm in height, compared to 4 mm in width, 0.3 mm in height endoscopically. On diagnosis of the depth of invasion, the depressed type of cancers without ulcer scars and with granular depressions were mostly limited to the mucosa, on the other hand, clear depression and plateau like elevation were highly indicative of submucosal invasion. In cases of elevated cancers, a central depression was highly indicative of submucosal invasion.