Studies on the Clinical Evaluation of the Preoperaive Selective Celiac and Superior Mesenteric Arteriography to Determine the Stage of Gastric Cancer

For evaluating preoperative selective celiac and superior mesenteric arteriography to determine the stage of gastric cancer, we analyzed the vascular pictures of 380 patients who had undergone angiography before primary operations for gastric cancer, compared them with operative and histopathological findings and calculated the “coincidence rates” (compared with operative findings), “correct rates” (compared with histopathological findings) and rates of false-positive and false-negative angiographic diagnoses, concerning the factors of disseminating peritoneal metastasis, liver metastasis, lymph node metastasis and serosal invasion. The overall coincidence rate for the presence of disseminating peritoneal metastasis was 93.4% and that of liver metastasis was 96.3% but the ability to diagnose comparatively small liver metastases was not good; the rate of H1 and H2 was 16.7% and 66.7% respectively. The overall correct rate for the presence of lymph node metastasis was 51.4% and the false-negative rate was high, 47.8%. Lymph node metastasis was, in most cases, detected by tumor staining of lymph nodes and the tumor stain was frequently seen in the cases of histologically well-differentiated type. The overall correct rate for the presence of serosal invasion was 81.6%, and 43 cases of S3 such as pancreaic invasion were diagnosed by angiography. Angiography was considered to be one of the most useful methods for preoperative diagnosis of to stage of gastric cancer, particularly of disseminating peritoneal metastasis, liver metastasis and S3 of pancreatic invasion.