To evaluate the clinical value of gastric cytology in the detection of stomach cancer, the results of cytological examinations in 417 cases of early cancer of the stomach in which cancer cell infiltration was limited to the mucosa or submucosa were analyzed. The cytological examination revealed positive for cancer cells in 93% of these cases, and therefore it is concluded that this method is not only useful but indispensable for the diagnosis of early cancer of the stomach. The gastric cytology proved to be more reliable than the endoscopic and X-ray examinations in terms of detection rate of the early gastric cancer. Among various cell collection methods for gastric cytology, which include the washing, abrasive and fibergastroscopic methods, the washing method under direct vision by the use of fiberscope showed the highest value of positivity (92.8%) in the cases of early cancer of the stomach.With the help of endoscopic guidance and biopsy tech niques, the cytological examination further increased its reliability and ability in the detection of early gastric cancer. Cancer lesions even smaller than 1 cm can now be correctly diagnosed by the gastric cytology. gastric cancer; cytological diagnosis; direct-vision cytology of the stomach With the improvement in X-ray and endoscopic examinations, detection of the superficial or minute lesions of the gastric mucosa became possible. The ultimate diagnosis of malignancy is only made on the basis of histological criteria and by detecting the cancer cells. For the evaluation of exact nature of lesions discovered by radiology and/or endoscopy, the gastric cytology can yield definitive information at a microscopical level. The recent development of elaborate and delicate fibergastroscopes that permit cytological sampling under direct vision has enormously facilitated the cell collection from the stomach, and the device adopted did not reduce the capacity of the fibergastroscope in detecting cancer (Ishioka et al. 1965(Ishioka et al. , 1970Yamagata et al. 1966;Fukuda et al. 1967;Kasugai 1968a Kasugai , b, 1973Kobayashi et al. 1970;Prolla et al. 1971; Prolla and Kirsneer 1972;Shida and Ishioka 1973). In order to evaluate the clinical significance of the cytological ex amination in the diagnosis of cancer of the stomach, the present authors analyzed the results of cytology in 417 cases of early gastric cancer, in which cancer cell infiltration was limited to the mucosa or the mucosa and submucosa. The five
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