Macroscopic characteristics of depressed type early gastric cancer special reference to their mucosal localizations

Macroscopic characteristics of 143 lesions from 138 cases of depressed type early gastric cancer less than 2.0cm in the major axis (74 lesions of undifferentiated cancer, 69 lesions of differentiated cancer) were studied with respect to the localization in the gastric mucosa divided into 3 areas (area F : fundic gland region, 36 lesions, area I : intermediate gland region, 29 lesions, area P : pyloric gland region, 79 lesions). (1) All 36 lesions in the area F were of the undifferentiated type. Narrowing and/or interruption of the folds were found in 83%. The abnormal folds were found in 97% of the lesions found in the area where the mucosal folds were present. (2) 72% lesions in the area I were determined to be undifferentiated cancers. Uneven depressed surface was observed in 95% of the undifferentiated cancer. Steep depressed margine was found in their 86%. Narrowing and/or interruption of the folds were detected in their 81%. In cases of differentiated cancer, the findings of folds both on the depressed surface and margin were scarcely observed. (3) The undifferentiated cancer was diagnosed in 22% of the lesion in the area P. In 18% and 76% of them, uneven depressed surface and steep depressed margin were observed respectively. Narrowing and/or interruption of the folds were recognized in only 6%. Although these abnormal macroscopic findings were less in this area, the marginal elevation was found in 59%. In differentiated cancer of this area, the presence of marginal elevation was the highest up to 72% compared with cancers in the other areas.