陥凹性小胃癌の診断―X線の立場から

Diagnosis of Small Gastric Cancer of Depressed Type―From the Point of Roentogenography

要旨　外科的あるいは内視鏡的に切除され，切り出し時の肉眼所見で大きさが1cm以下と記載された陥凹性胃癌187病変を対象とし，癌浸潤範囲が固定標本の肉眼所見と組織所見でほぼ一致するもの（一致群）と一致しないもの（不一致群）とに分類し，不一致群21病変の形態学的特徴像とX線検査，内視鏡検査の診断能を比較検討した．不一致群の肉眼型は随伴IIbを伴う病変14病変，IIc7病変（類似IIbと線状の伸び出しを伴う病変）であった．不一致群においてX線検査と内視鏡検査の性状診断能，範囲診断能，深達度診断能に有意差はなかったが，深達度診断能はX線検査のほうが内視鏡検査に比べ正診率は高かった．

　We reviewed 187 lesions of gastric cancer of depressed type resected surgically or endoscopically, the size of which were less than one centimeter in the gross finding of the fixed specimen. We classified them into two groups from the correspondence in the area of cancer involvement between the gross and microscopic findings, and compared the morphological features and the performance of visualization in roentogenography and endoscopy. Th types in the group lacking in correspondence between gross and microscopic findings were 14 lesions accompanied with IIb and 7 IIc accompanied with IIb-like lesions or spicula. In this group, there was no significant difference between roentogenography and endoscopy in the performance of visualization of the malignant finding, the extent of cancer, and the depth of the involvement. As for the diagnosis of the depth of the cancer, the ratio of the cases correctly diagnosed was higher in roentogenography than in endoscopy.