早期胃癌の転移―胃癌研究会から

Metastasis from Early Gastric Cancer: Analysis of the Nationwide Registry and the Reports for the Japanese Research Society for Gastric Cancer

要旨　早期胃癌の転移の実態を多数例の集計から検討した．全国胃がん登録から5年分を集計すると，m癌13,951例，sm癌11,683例のリンパ節転移率はそれぞれ2.3％，16.7％であった．また，胃癌研究会の主題としてm癌およびsm癌が取り上げられた際の抄録からリンパ節転移について集計すると，m癌2.1％，sm癌17.7％という転移率となった．m癌では，潰瘍(瘢痕)を伴う陥凹型，未分化型，腫瘍径が大きい，の3点がリンパ節転移例の特徴として挙げられていた．早期胃癌の同時性血行性転移は極めてまれであった．病理検索方法により深部浸潤やリンパ節転移の検出に差が生じることを常に念頭に置くことが重要と思われた．

　To know the actual state of metastasis from early gastric cancer (EGC), we studied a large number of patients using the database of and the abstracts reported for the Japanese Research Society for Gastric Cancer (JRSGC). A total of 25,634 EGC cases were registered in the Nationwide Registry for the JRSGC between 1984 and 1988, and 2.3％ of mucosal and 16.7％ of submucosal carcinomas had lymph node metastasis at the time of operation. Reviews of the abstracts for the 63rd and the 65th Meetings of the JRSGC, in which EGC was the main theme, showed similar metastatic rates. The majority of mucosal tumors with metastasis were associated with ulcerative changes, large tumor size, and histological undifferentiation. Hematogenous metastasis from EGC was extremely rate. Pathological methods for examining the resected specimens considerably influenced the metastatic rates, and should always be considered in discussion of this subject.