X線診断の立場からみた食道癌の発育進展―初期病巣から粘膜下層癌へ

Natural Progression of Esophagus Cancer Viewed from a Standpoint of X-ray, especially Focusing of the Early Features from the Initial Lesion to the Submucosal Cancer

要旨　深達度smの食道表在癌6例に対して，過去のX線像または内視鏡像をretrospectiveに検討し，食道癌の初期病巣から粘膜下層癌への発育進展についてX線診断の立場から考察した．深達度mの初期病巣がsm癌へと発育進展する際の肉眼形態の変化としては，①0-IIc型→0-I型，②0-IIc型→O-III型，③0-IIc型→O-Ilc型，④0-Ilc型→O-1+IIa+IIc型，⑤0-IIb型→0-1+IIa+IIc型の5通りのパターンに分かれ，発育速度はパターン①，②はパターン③，④よりも速い．パターン⑤は臨床期が短く，見かけ上は最も急速に見えるが，速度はパターン④に準じると推測された．

　Six cases of superficial esophagus cancer, all sm, were reviewed retrospectively in terms of either x-ray images or endoscopic images of the past. The growth or natural progression of esophagus cancer commencing the earliest possible stage (initial lesion) and gradually invading the submucosal layer was scrutinized from a standpoint of x-ray.

　Morphological alterations where initial lesion of m develops into sm slowly and steadly were split into five patterns. ①Type 0-IIc to Type 0-I, ②Type 0-IIc to Type 0-III, ③Type 0-IIc to Type 0-IIc, ④Type 0-IIc to Type 0-I+IIa+IIc, ⑤Type 0-IIb to Type I+IIa+IIc.

　Pertaining to growth velocity, patterns 1 and 2 are faster than patterns 3 and 4. Pattern 5 with the short clinical stage (period of time possible to perceive the lesion) seemingly shows extremely rapid growth, but not in fact, it conforms to pattern 4.