Abstract

Objectives of the study; In the past few years, the diagnosis of early gastric cancer of stomach has been improved. The clinical symptoms and statistics of early gastric cancer have been reported at several occasions, in which histopathology has been rather lightly presented. The purpose of this study is to analysis some reasons that incidence of early gastric cancer is lower than the incidence of advanced gastric cancer in Korea. This study also aims to examine the gross and microscopic findings in order to strengthen the bases of diagnosis of early gastric cancer in the process of biopsy and gastrectomy specimen. Methods and materials; It is the author's intention to describe in details about histopathology of eleven cases of early gastric cancer with gastrectomy specimens, which were operated at Okinawa Central Hospital, Okinawa, Japan During 18 months from March 1973 to August 1974, according to age, sex, classification, size, depth of invasion, lymph node metastasis and histopathology. The author's also intents to compare 40 cases of gastric cancer at O.C.H. with 29 cases of gastric cancer operated at Ewha Womans University Hospital, Seoul, Korea, during 11 years from 1964 to 1975. The comparison and analysis will be made in terms of age, sex, duration, location, lymph node metastasis, depth of invasion, incidence of early cancer. Results and summary; The highest incidence of early cancer among the 11 cases at O.C.H. revealed in the age groups of 60's and average age was 58. M F ratio was 2.7 to 1 with male predominance. The classification of early gastric cancer revealed 2 cases of Type I, 3 cases of Type IIa, 3 cases of Type IIa, 3 cases of Type IIc, 2 cases of Type III, 1 case of Combined Type (IIc+III) with slightly predominance of Type IIc, and its combined type. The size of early gastric cancer measured from 0.3cm. to 3.0cm. With average of 1.2cm. in greatest diameter. The depth of invasion was within mucosa in 8 cases and within submucosa in 3 cases. Most common sites were the lesser curvature of angulus and antrum. All cases were negative for metastatic lymph nodes. The histopathology of early cancer revealed: Papillary type (1), Polypoid type (1), Signet ring cell type (3), Small tubular type (2), Small tubular type (2), Well differenciated type (3), Undiff. Small cell type (1). In comparison of 29 cases gastric cancer at E.W.U.H. with 40 cases gastric cancer at O.C.H., M F ratio was 1.5 to 1 with a slight higher incidence over male at E.W.U.H. and 2.5 to 1 at O.C.H. Number of metastatic lymph nodes was higher at E.W.U.H with 70% than O.C.H. with 57%. The incidence of early gastric cancer was considerable lower at E.W.U.H. with 3.8% in all cases of gastric cancer than O.C.H. with 27%. In conclusion, the Korean people generally visit to hospital at the fairly advanced stage of gastric cancer, resulting a poor prognosis after surgical treatment. The main reasons of such a phenomenon in Korea are considered to be (1) inadequacy of health insurance, (2) insufficient understanding on early gastric cancer, and (3) a short of availability of diagnostic facilities.