集団検診からみた胃癌の発育進展

Development and Progress of Gastric Cancer from the Viewpoints of Gastric Mass Examination

要旨　1992～1994年度の当協会の胃集検受診者717,199名から発見された胃癌1,011例の中で集検受診前歴のある進行癌202例の，5年間の前歴フィルム延べ478件を見直すことにより胃癌の発育進展の検討を行った．検討にあたり，消化性潰瘍の有無と癌性隆起の有無により発見癌をⅠ型からⅥ型の6種類に分類した．年単位の期間別示現率を分析すると，ⅠA，ⅡA，ⅢAなどのUl（－）群で示現率が低く，形態変化の速い癌と考えられた．一方，ⅤA，ⅥAといったUl（＋）の癌は示現率が高く，形態変化の遅い癌と考えられた．また，これらの進行癌の前身の早期癌の型としてはⅠAはⅠEから，ⅡAはⅡEとⅢE，ⅢAはⅢE，ⅤAはⅤEとⅥE，ⅥAはⅥEからの進展例が多く観察された．

　Among 1,011 cases of gastric cancer detected by our association's gastric mass examination out of 717,199 examinees during the period between 1992 and 1994, 202 cases of advanced cancer who had previously undergone screening examinations were evaluated for the development and progress of cancer by reassessment of the previous 478 x-ray films for six years prior to detection. For the evaluation purposes, the detected cancers was classified into six types (Type Ⅰ to Ⅵ) by the presence of peptic ulcers and carcinomatous protrusions.

　By the analysis of the annual lesion appearance rates, rates were low for the cancers of Ul(－) group, such as the Types ⅠA, ⅡA and ⅢA, which indicated that the cancer without peptic ulcers may showed rapid morphological changes. On the other hand, the annual lesion appearance rates were high for cancers of Ul(＋) groups, such as the Type ⅤA and ⅥA, which suggested that the cancer with peptic ulcers may progress slowly. Our study estimated the relation between previous and current shapes of the advanced gastric cancer as follows: Type ⅠA may develop from Type ⅠE, Type ⅡA from Types ⅡE and ⅢE, Type ⅢA from Type ⅢE, Type ⅤA from Types ⅤE and ⅥE, and Type ⅥA from Type ⅥE.