早期胃癌診断の実際―ひだ集中を伴う陥凹性病変：X線所見

Radiographic Diagnosis of Depressed Type Early Gastric Carcinoma with Fold Convergency

要旨　陥凹型早期胃癌の診断にあたっては，癌組織型による差を把握しておくことが重要である．多彩な胃癌組織型を分化型癌と未分化型癌とに2大別すると，X線および肉眼所見から組織型別の診断が可能となる．その基本となる所見は，①陥凹面，②陥凹縁，③粘膜ひだ，④ひだ集中の4つである．胃癌の性質，すなわち癌発生の場，発育形式，肉眼所見など組織型別の差を十分に把握したうえで，これら4つの所見をもとに病変の組織学的な成り立ちを推定していくことが診断の基本である．

　In the diagnosis of depressed type early gastric carcinoma, it is mandatory to detect the histological character of the carcinoma before surgery.

　It is possible to make differential diagnosis of differentiated type and undifferentiated type carcinoma, based on the radiographic findings of the depressed area, margin of the lesion, mucosal fold ends and the manner of fold convergency.

　The histological component of early gastric carcinoma with fold convergency could be predicted by precise interpretation of radiographic findings involving these four factors.