위절제술을 시행한 조기위암환자에서 위치확인을 위한 위장조영검사와 위내시경검사의 비교분석에 따른 진단률 향상에 관한 연구

A Study Improvement of Detection Rate according to Comparative Analysis of Endoscopy & UGI for Localization in Early Gastric Caner with Gastrectomy - Around of EGC≦4cm -

Purpose : It was prepared to help patients with early gastric cancer who underwent a gastrectomy to detect early gastric cancer by comparing observations from pre-operation UGI series and Endoscopy as well as post-operation pathological observations of type, size, and location. Materials and Methods : It targeted 27 cases who underwent a gastrectomy for early gastric cancer by visiting the department of surgery from February 2007 to September 2008 while the pathological observations of type, size, and location were compared and analyzed through observations from pre-operation gastroscopy and UGI series and medical record after the gastrectomy. Results : Considering the generation frequency after gastrectomy, pyloric antrum was the most with 15 cases (55.6%); specifically, lesser curvature of stomach was the most with 14 cases (51.9%). When 2 accompanied observations were combined, atrophic gastritis and intestinal metaplasia showed high frequencies with 23 cases (85.2%) and 22 cases(81.5%) respectively. Through radiologic severity, 14cases (51.8%) were judged as “concordance” while 13 cases (48.2%) were judged as “discordance”. In the origin site of the 13 cases judged as “discordance” in radiologic severity, pyloric antrum was the most with 9 cases (69.2%); specifically, lesser curvature of stomach was the most with 6 cases (41.6%). Lesser curvature and the anterior wall part of stomach are difficult to be technically depicted minutely during the UGI series, and they are parts where false positive rates are frequently generated. Conclusion : Observation of accompanied intestinal metaplasia(81.5%) is evaluated as the important standard in the discovery of early gastric cancer. Intensive tests are executed for intestinal metaplasia because it is considered as a high risk group and require follow up when suspected. In the result of radiologic severity, there were many observations which looked normal yet it was early gastric cancer in lesser curvature and the anterior wall of stomach including the gastric angle. Only habitual scans of that part with compression and flow technique, while at the same time, confirming the change of mucosa are thought to contribute to discovering early gastric cancer exactly and swiftly in gastric cancer screening tests.