Studies on the lavage cytology of the stomach cancer under direct vision

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As a method of gastric lavage cytology, a washing method with acetate buffered solution containing α-chymotrypsin has been used widely because of a simple apparatus and easy technique and good results. Therefore this procedure became a routine method for gastric cytology. However washing by this procedure was not so effective to obtain cells from a small lesion such as early gastric cancer because the washing was blind.In order to improve this procedure we invented a new apparatus which was a Hirschowitz's fiberscope attached a nasogastric tube, and presented an idea and procedures of lavage cytology under direct vision, which was a method to obtain cells by direct washing observing the lesion by this apparatus. In 1965 Fiberscope-K type based on our ideas for gastric lavage cytology under direct vision was made by Machida Company. With this Fiberscope-K type excellent results were obtained. As a new apparatus in which the angle of a nozzle to spout washing solution can be changeable was invented in early 1966, direct washing for any lesion of the stomach became possible without any difficulities. Thereafter GFC with an angle and FGS-C were made and recently FGS-CL with a light-guide was invented.Diagnostic accuracy had increased remarkably by this procedure. The diagnostic accuracy was 96.4% for all stomach cancers and 94.4% (corrected diagnostic accuracy 97.1%) for early cancer respectively.In the early time when this procedure was begun, the location of a lesion in the stomach affected greatly making an accurate diagnosis. But this problem regarding the location of a lesion was resolved with the improvement of instruments.The advantages of this procedure are as follows.1) As the lesion can be washed directly, good results in diagnosis of a small lesion such as early cancer can be obtained.2) Cancer cells are easily exfoliated for strong washing, and many cancer cells as group can be obtained.3) Degeneration of cancer cells is little because enzyme is unnecessary as physical power is used for washing and washing time is short.
財団法人日本消化器病学会の論文

Studies on the lavage cytology of the stomach cancer under direct vision

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