胃癌の新肉眼分類における使用上の留意点―治療の立場から

Notes for Using a New Classification of Gastric Cancer: From Clinical Point of View

要旨　胃癌取扱い規約の今回の改訂においては，肉眼型の判定を臨床，手術，総合の3段階で行い，加えて推定深達度（T）を付記することになった．これにより，旧分類の5型に組み入れられていた，いわゆる早期癌類似進行癌を分離することができた．これらのことから手術前に肉眼型を把握することで癌腫の拡がりの程度が予想され，内視鏡治療や縮小手術，合理的リンパ節郭清の良い指標となると考えられた．

　In this revision, macroscopic findings are judged at the clinical stage, at the time of operation, and also from an overall point of view. To this determination is added a description of the estimated depth (T) of the cancers.

　This revision makes it possible to distinguish the socalled early cancers resembling advanced cancers which were formerly classified as type 5 cancers.

　Based or this revision, a clearer understanding of the macroscopic findings before the operation enables the surgeon to make a better estimation of the extent of the cancer. This becomes a guideline for endoscopic therapy, for limited resection operations, and for more reasonable nodal dissections.