Sensitivity of endoscopic detection of malignancy in resectable gastric carcinoma

In 50 consecutive cases of resected gastric carcinoma the absolute sensitivity in making an unequivocal pre-operative diagnosis was 54% for endoscopic inspection, 76% for biopsy and 48% for cytology. Inspection and biopsy in combination yielded 90% and adding cytology achieved 92% absolute sensitivity. The relative sensitivity (which included equivocal reports) was far higher for each individual test, and 100% for the combination of all three, but did not reflect the clinical value of these investigations as clinicians did not react appropriately to equivocal reports. Thus for the endoscopic detection of gastric carcinoma in routine clinical practice, inspection was insensitive, biopsy mandatory, cytology of little additional value and endoscopic followup of apparently benign lesions appeared important.