Early gastric cancer: radiographic experience

Early gastric cancer (EGC) is currently defined as an adenocarcinoma limited to the mucosa or to the mucosa and submucosa with or without perigastric lymph node involvement. To evaluate the radiologic features of this tumor, the radiographs of 21 cases were reviewed. Four were Type I (protruded) tumors, eight were Type II (superficial) including two mixed lesions, and nine were Type III (excavated), containing evidence of true ulceration. A retrospective analysis of radiographic findings indicated that nine of the tumors (43%) were either suspicious or diagnostic for malignancy on at least one examination, four (19%) were thought to be benign, and eight (38%) showed no identifiable lesion in the region of the stomach subsequently shown to contain an early cancer. The location, size, histology, gross morphology, and survival data, even in the face of perigastric lymph node involvement, all suggest that the early gastric cancer reported in this and other Western series is the same as that reported by the Japanese. The data further suggest that the incidence of EGC in the West is higher than traditionally thought.