4) 平坦・陥凹型早期胃癌の拡大内視鏡所見と鑑別診断

Magnifying Endoscopic Examination and Differential Diagnosis of Flat or Depressed Early Gastric Cancer

要旨　拡大内視鏡で観察される平坦・陥凹型早期胃癌の胃粘膜微細模様（fine gastric mucosal pattern；FGMP）は緻密化や大型化を呈する不規則なD patternが主体を成し，これに模様がほとんど観察されないN patternを伴うこともある．N patternは癌のみに観察され，腺腫との鑑別に有用である．また，拡大観察で初めて観察される病変部の微細不規則血管も癌で高頻度（97.5％）に観察される所見であり，出現頻度は低い（14.8％）が癌に特異的に観察される通常観察でも観察可能な悪性新生血管とともに良・悪性鑑別診断に有用な拡大内視鏡所見である．

　The major fine gastric mucosal pattern (FGMP) of flat or depressed early gastric cancer is the elaborated or largesized irregular D pattern which it is sometimes accompanied by the N pattern (this pattern is difficult to discern even by magnifying endoscopy). N pattern is found only which cancer exists, so it is useful for the differential diagnosis of carcinoma and adenocarcinoma. The fine proliferated vessels which were found especially in gastric cancer (97.5％) only by magnifying endoscopy and the malignant regenerative vessels which were found even by the ordinary endoscopy not in adenoma but in cancer (14.8％) were very useful magnifying endoscopic findings for differential diagnosis of the lesions.