噴門部領域の癌の病理診断

Pathologic Characteristics of Cancer in Periphery Region of Esophagogastric Junction

要旨　噴門部領域癌の病理学的特徴を検討した．本来はEGJ前後2cm以内にとどまる癌を検討すべきであるが，症例数が少ないために4cm以下で癌の中心部が2cmにとどまる症例（68例）を他部位の4cm以下の癌と比較して検討した．噴門部領域癌は，食道癌と胃癌のうち3.1％であり，70歳以上の高齢者が多かった．組織学的には高分化型腺癌（特に乳頭腺癌）が多く，肉眼的には組織型を反映して隆起型や限局潰瘍型が多かった.リンパ節転移率や再発死亡率は他部位の胃癌に比べて高く，食道癌と同様で悪性度が高かった．

　Two thousand two hundred and seventeen cases of gastric and esophageal carcinoma smaller than 4 cm were examined to find out the pathologic characteristics of cancer in the cardiac region. Carcinomas in the periphery region of the esophago-gastric junction were 68 cases (3.1%) out of the 2,217 cases. Compared with other sites of gastric cancer, cancer cases in the periphery region of the esophago-gastric junction were in the higher age group and had a higher rate of papillary adenocarcinoma in histologic type, a higher rate of elevated types and localized ulcerative types in macroscopic type, and a higher rate of cancer death in cases with more than a five-year follow period. In this respect, its data was the same as data concerning esophageal cancer. On the other hand, except for Barrett carcinoma, esophageal carcinoma in the cardiac region was not remarkably different from esophageal cancers at other sites. We concluded that the periphery region of the esophago-gastric junction could be location for gastric cancer.