Endoscopic gastric mucosal resection (EGMR) is increasingly employed in early gastric cancer to remove the tumour with the surrounding mucosa and part of the submucosa after submucosal saline injection and staining to define the extent of the lesion. This study presents preliminary experience with a modified EGMR technique in five patients which allows more precise targeting and resection of the lesions. The time required for this procedure was less than 30 minutes in each case. All lesions were completely removed. In two patients, however, tumour growth invaded the submucosa and these patients therefore underwent subsequent surgery. Three patients with carcinoma confined to the mucosa were tumour-free at follow-up with repeat endoscopy and biopsy after 7 to 23 months.

We examined the histological characteristics of the foveolur zone of the gastric body mucosa, using dye endoscopy and endoscopic biopsy. In 63 patients, the gastric area type of the gastric body was placed in one of the following categories ; fundic gland type 0 (Fo), where small and fine areas are arranged closely to one another ; F I , where the areas are largest in size, round and high ; F z , where the areas are intemediate in size but not so high ; F3, where small and flat areas are loosely arranged ; pseudo-pyloric gland ty$e 1 (Pbr), where the areas are regular in size and arrangement; and the completely atrophic gland type (Pbz) with areas irregular in size and arrangement. The histological characteristics of the foveolar zone were emmined o n printed microphotographs of the biopsy specimens of the gastric body. The density of the gastric pit was defined as the number of pits in a 1 mm width of the mucosal surface and depth of the foveolue was measured as the distance between the top and bottom (or the isthmus) of the foveolue as seen on vertical sections. The gastric pit density and depth of the foveolue were dense and shallow, respectively, in FO and sparse and deep, in Pbl and Pbz respectively. The degree of these factors showed independency in area types Fo, F I and Pbz and there were correlations of P

We investigated the endoscopic and histopathological characteristics of 112 gastric polyps on the gastric body. According to the histopathological findings of the glands in the biopsy specimens, we classified the polyps into 6 categories; dense fundic gland type (group A), sparse fundic gland type (B), mixed fundic and pyloric gland type (C), pyloric gland type (D), complete atrophic gland type (E) and others (F). The grade of atrophic gastritis was defined by the fundic‐pyloric border type of the stomach, and was found to change from mild to severe respectively in groups A to E. The gastric area type of background fundic gland mucosa also changed from F0 to F3 in parallel with the order of the groups A to E. Thirty‐five of the 36 polyps in group A, all 19 in group B, 2 out of 3 in group C, 1 of 4 in group D, and the 1 in group E were located on the dye‐endoscopically defined fundic gland mucosal area. The gland type of biopsy specimens which were obtained from the mucosa adjacent to the polyps changed from fundic to fundic‐pyloric and to pyloric type in groups A to E respectively. In conclusion, the histopathological findings of polyps on the gastric body reflect the background mucosa, and in particular the extent of the atrophic change of the stomach. The majority of polyps, either fundic gland polyps (groups A and B) or hyperplastic polyps (groups C, D and E), on the gastric body were found to be the same gland type as their respective background mucosa. They thus seem to fall into the same category as hyperplastic polyps of background mucosal origin but are not the same as a hamartomatous polyp.

We experienced two cases of superficial type esophageal cancer. Case 1 was a 72-year-old man in whom endoscopic examination revealed a slightly protruded, partially reddened and faded area of irregular shape corresponding to 0-IIa + IIc (slightly depressed type) of the endoscopic classification of esophageal cancers. Macroscopically, it was a superficial, ill-defined and non-cicatrized solitary tumor measuring 2.5 x 2.4 cm in size. Histologically it was a monofocal semidifferentiated squamous cell carcinoma of a swelling type of stage 0. Case 2 was 55-year-old man. Endoscopic examination disclosed an almost roundish, smooth-surfaced, flat and dull red area corresponding to IIc (slightly depressed type). Macroscopically it was a superficial, semidefined and non-cicatrized solitary tumor measuring 1.0 x 1.0 cm in size. Histologically it was a monofocal, semidifferentiated squamous cell carcinoma of stage 0. To detect esophageal cancer at an early stage, the endoscopist needs to inspect the mucosa carefully. In case of males aged over 50, the endoscopist would be well advised to employ the dye-spraying method (Lugol staining method) at the endoscopic examination.

No abstract