経過観察例からみた胃癌ハイリスクグループ―胃X線検査の立場から

High Risk Group for Gastric Cancer Revealed by the Degree of Atrophy Discovered by X-ray

要旨　目的：X線的胃粘膜萎縮度からみた胃癌ハイリスクグループの抽出．対象：胃癌発見3年以上前のX線画像の見直しが可能であった逐年受診発見胃癌82例．方法：発見3年以上前のX線画像における萎縮度（grade 1～3）と発見胃癌の臨床病理学的因子の関係の分析．結果：単変量解析では萎縮度別に，年齢（歳），性別（女性，男性），F線領域（F線内部，近傍，外部），肉眼型（陥凹型，隆起型），組織型（未分化型癌，分化型癌）に有意差が認められた．多変量解析ではF線領域と組織型が独立した危険因子で，grade 1と萎縮が弱いほどF線内部領域，未分化型癌の発生リスク，grade 2，3と萎縮が強いほどF線外部領域，分化型癌の発生リスクが高かった．結論：より的確な癌発見のためには，X線的萎縮度別にF線領域と組織型を考慮した撮影・読影体制を構築する必要がある．

　Aims : From the degree of gastric atrophy detected by X-ray used in annual screening we tried to clarify the characteristics of gastric cancer that might be expected to develop.

　Material : 82 cases of gastric cancer clearly verified by histology.

　Method : We analyzed the clinico-pathological factors related to the degrees of atrophy（grade 1～3）reversed in X-ray images taken three years previously.

　Results : In a univariate analysis, a meaningful difference was recognized by the age, sex, F boundary line area macroscopic type and a histological type. However, only the F boundary line area and histological type were independent factors.

　Conclusions : It is necessary to build a reading system in X-ray for gastric cancer screening that considers the F boundary line area and the histological type in relation to the gastric atrophy degree shown by X-ray in order to discover cancer more precisely.