大腸sm癌の診断―X線の立場から，特に正面像による深達度診断

Diagnosis from the Radiographic Standpoint of Submucosal Cancerofthe Colon: Special Attention to Diagnosis of the Depth of Infiltration Viewed en Face

要旨　大腸sm癌の特徴像を明らかにする目的にて大腸癌174病変（m73病変，sm50病変，pm51病変）を対象としX線検査による深達度診断の指標を検討した．深達度は，腺腫成分が多いほど浅かった．無茎性隆起で丈の低い病変は大きさからみるとばらつきが大であったが，表面性状パターンの差は腺腫成分の有無の鑑別にある程度有用であり，さらに深達度診断のより細かい指標となった．中心陥凹を伴う隆起型は，1cmを越えるとpm癌の可能性が生じ，2cmを越えると全例pm癌であった．隆起表面の性状，また浅い陥凹の描出にX線検査による微細診断学の手法を応用すれば深達度診断の精度はより高まると思われた．

　Radiographic clues to the diagnosis of the depth of cancer infiltration were studied to clarify morphologic characteristics of submucosal cancer of the colon. The material studied included 174 lesions of colon cancer (m:73, sm:50, and pm:511esions). The depth of cancer correlated with the size of lesions, and conversely correlated with adenomatous components. There was no advanced cancer in pedunculated elevations. Possibility of advanced cancer occurred in tall sessile lesions more than 2cm in size and in short sessile lesions more than 1cm in size. The size of short sessile lesions were variable. However, recognition of superficial mucosal pattern was usefull for discrimination of the existence of an adenomatous component and was a more detailed clue for the diagnosis of the depth of cancer infiltration. Some of the elevated lesions with central ulceration more than 1cm in size, and all of those lesions more than 2cm in size were advanced cancer. Reliability of the diagnosis of the depth of cancer infiltration would be increased if detailed radiography is performed in which superficial mucosal features and shallow depression of elevated lesions are demonstrated.