THE TITLE of this paper immediately poses the question, "What kind of lesion is representative of an early cancer?" Obviously, the answer varies from observer to observer. A small tumor that is diagnosed radiologically may show an advanced, widely infiltrating neoplasm on microscopic examination. Cytodiagnosis should aim at the detection of cancer in its earliest stage when other diagnostic techniques fail. Cytologic diagnosis foretells only the presence of a neoplasm; it is not capable of defining its histological type, its extent, or the location of the lesion. In the absence of positive radiologic or gastroscopic findings, one can hope to uncover a carcinoma in situ or a superficial intramucosal carcinoma, carcinomata that promise a reasonable prognosis after excision.
Histologic studies have shown that the growth of a gastric cancer passes through the same phases as cancer in other situations. We recognize, therefore, a carcinoma in situ that is confined to