逐年検診からみた胃集検発見胃癌の特徴

Characteristic of Gastric Carcinoma Detected by Mass Survey at One Year Interval

要旨　逐年検診群（以下逐年群）176例と，非逐年検診群（以下非逐年群）386例とを，発見癌の占拠部位・大きさ・肉眼型・深達度・組織型について比較した．早期癌率は，逐年群68％，非逐年群53％で，逐年群が有意に高率であった．進行癌に占めるpm癌の割合は，逐年群29％で非逐年群19％より高い傾向がみられた．肉眼型・部位では，Ⅱc類似進行癌が逐年群で多い傾向があり，逐年群でA領域後壁・C領域前壁の癌の割合が高かった．手術時4cm以上の進行癌のうち，前年間接無所見例は10例であった．組織型は10例中9例が未分化型で，部位ではC領域が5例と多かった．逐年検診でもC領域および未分化型で発育が速いものは進行癌で発見される可能性が高い．

　We experienced 176 gastric carcinomas detected by mass survey at one year interval (group Ⅰ) and 386 gastric carcinomas detected by mass survey at two or more years interval (group Ⅰ, including those detected for the first time). These two groups were compared with respect to depth of invasion, location, size, shape and histological type.

　The proportion of early gastric carcinoma was significantly higher for group Ⅰ (68%) than for group Ⅱ (53%). In advanced carcinoma, the incidence of lesion limited to muscularis propriae was higher for group Ⅰ (29%) than for group Ⅱ (19%). Regarding the location, posterior wall of the lower third (A) and anterior wall of the upper third (C) were commoner for group Ⅰ than for group Ⅱ. There was, however, no significant difference in size, shape and histological type.

　Group Ⅰ included 10 cases of advanced carcinoma, 4 cm or more in size, which had not been shown on photofluorogram taken at one year before detection. Nine of these 10 cases were undifferentiated type in histology, and 5 of them were located at the upper third of the stomach. Therefore, the carcinoma of undifferentiated type with rapid growth and the one located at the upper third of the stomach are likely to be detected only at an advanced stage in spite of mass survey at one year interval.