日本における肛門部腫瘍の集計

Primary Anal Tumors in Japan

要旨　われわれは，1999年1月から2003年2月までの間の肛門腫瘍例を医学中央雑誌より抽出，集計した．(1)のべ症例数は293例であった．病変別頻度は，肛門管癌122例，悪性黒色腫86例，Paget病31例，痔瘻癌24例，Bowen病7例，顆粒細胞腫5例，基底細胞癌3例，その他15例であった．(2)肛門管癌の組織型別頻度は，腺癌42例，扁平上皮癌33例，粘液癌18例，類基底細胞癌11例，印環細胞癌4例，未分化癌4例，その他5例であった．(3)肛門管癌では3cmを超える病変が61.5％を占めた．(4)出血，痛み，腫瘤が三大症状であった．(5)肛門管癌では，直腸切断術施行頻度は20年前に比べると少なくなり，放射線化学療法がより多く行われつつある．

　We have reviewed Japanese case reports of primary anal tumors which have been cited in the Igaku Chuoh Zasshi in the last four years and two months (1999-1～2003-2). The results were summarized as follows;

　1)Total number of cases was 293. Primary tumors classified according to histology and relative frequency in the new series were; anal canal cancer 122, malignant melanoma 86, perianal Paget's disease 31, anal fistula cancer 24, Bowen's disease 7, granular cell tumor 5, basal cell carcinoma 3 and others 15.

　2)Anal canal cancers classified histopathologically and accoding to relative frequency were; adenocarcinoma 42, squamous cell carcinoma 33, mucinous carcinoma 18, basaloid carcinoma 11, signet ring cell carcinoma 4, undifferentiated carcinoma 4 and others 5.

　3)Anal canal cancers that were more than 3 cm in diameter account for 61.5％ of the total number.

　4)Bleeding, anal pain and palpable mass were the main symptoms.

　5)A comparison with a report 20 years ago has revealed that the relative frequency of rectal amputation surgery has decreased and that of chemoradiation has increased.