pre-linitis plastica型胃癌の形態的特徴―X線の立場から

Morphological Characteristics of Pre-linitis Plastica Type Cancer: From the Radiological Standpoint

要旨　予後不良な胃癌の1つであるlinitis plastica（LP）型癌の早期発見を目的に，X線診断の立場から検討した．胃上部における2cm以下の未分化型早期胃癌130病変のうち55病変（42.3％）がsm癌であった．130病変中13病変（10％）が中村の定義するpre-linitis plastica型癌に相当した．臨床的に発見されたprelinitis plastica型癌は12病変で，このうちひだ集中が発見の契機となった例は9病変（75％）であった．12病変のX線および肉眼所見の特徴は，陥凹境界明瞭でひだ中断が認められ，陥凹面の顆粒状変化に乏しいものが10病変（83.3％）と多かった． pre-linitis plastica型癌に限らず，胃底腺粘膜領域のm癌を含めた未分化型のⅡc病変を発見することがLP型癌の減少につながると思われた．

　We studied linitis plastica type cancer, one of the gastric cancers, of which prognosis is poor, from the standpoint of radiological diagnosis, for the purpose of early detection. Of 130 lesions of undifferentiated early gastric cancer (less than 2 cm in diameter) in the upper portion of the stomach, 55 lesions (42.3%) were sm cancer. Thirteen lesions (10%) of the 130 lesions corresponded to the signs of Pre-linitis plastica type cancer as defined by Nakamura. Twelve of these lesions were discovered clinically. In 9 lesions (75% of them), convergence of folds served as a clue to their discovery. Characteristics of radiological and macroscopic findings of the 12 lesions were sharply demarcated depression, interrupted folds and scarcity of granular changes on the depressed surface. These characteristics were found in as many as 10 of the 12 lesions (83.3%). The early detection of undifferentiated Ⅱc lesions including Prelinitis plastica type cancer and m cancer (in the fundicgland mucosa) will lead to better control of linitis plastica type cancer.