CHRONOLOGICAL CHANGES IN EARLY GASTRIC-CANCER

Background: Early gastric cancer, first described in 1908, became of c linical importance only after the introduction of fiberoptic gastrosco py with simultaneous biopsy. It was the purpose of our study to seek f or the concrete changes which took place in the distribution of early cancers after the introduction of these diagnostic tools. Material and Methods: Case records and histological slides of all 132 patients wit h early cancers among the 1,748 gastric cancers operated in the Robert -Rossle-Klinik were investigated for size of the tumor, results of dia gnostic methods, and surrounding mucosa. Results: Gastroscopy with sim ultaneous biopsy led to the detection of new types of early gastric ca ncer, smaller cancers, and cancers restricted to the mucosa. Investiga tion of the surrounding mucosa led to the detection of a remarkable pr oportion of patients with pangastritis. 6 of 8 patients with early gas tric cancer and a positive test for parietal cell antibody had pangast ritis, too. This is illustrating the fact that both endogenous and exo genous factors are operating together in the pathogenesis of gastric c ancer. Conclusions: Gastroscopy should not only be used to explore com plaints of patients, but also for the detection of early cancer and pr ecancerous lesions in all persons examined. Persons with autoimmune ga stritis and with histologically proven pangastritis should be included into an endoscopic follow-up program.