The close observation on the pathology in the stomach using gastroendoscope is essential for not only the differentiation between benign and malignant process but also the early detection of gastric malignancy.
Among the advanced stomach cancer, 217 cases were selected in this study by the radiologic, endoscopic and post-operative findings. They were classified into four Borrmann´s types depending upon the endoscopical macroscopic findings and were studied about the characteristics of each group.
The results obtained were as follows:
1) The most frequent occurrence of stomach malignancy appeared in the age group of fifth decade with an incidence of 32.7% and next comes fourth and sixth decade with a frequency of 29.0% and 18.0% respectively.
2) Borrmann type I, the fungating variety, was 41 cases (18.7%). The characteristic findings of the growth were relatively large polypoid mass with a broad base, which surface appeared to be nodular, hyperemic, hemorrhagic and sometimes necrotic in nature.
Most of the cases had a single mass, however multiple polypoid growth were also set in a few number of cases.
3) Borrmann type II , ulcer forming lesion, was found less frequently in an incidence of 13.8% (30 cases) and were the most confusable one with benign ulcer and Borrmann type III.
The ulcer margins were often nodular and elevated without any extent peripheral infiltration, and it was suggested that this group would become type III later stage.
4) Borrmann type III, the most frequent incidence appeared in a number of 177 case (53 9%), in which characteristics were in rich varieties in ulcer shapes, margins, converging mucosal folds and surrounding mucosal infiltration.
5) Borrman type IV were found in rare incidence (24 cases; 11%) with the specific findings such as diffuse mucosal infiltration with nodulation or giant folds in some cases.
Less advanced case of this type should de differentiated from chronic atrophic hyperplastic gastritis.
Five additional cases of undetermined type were also included this study.
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