リンパ節転移のあるUl（－）m癌の検討

Non-ulcerative Gastric Mucosal Cancer with Lymph Node Metastasis

要旨　これまでの早期胃癌に対する内視鏡的治療の適応の妥当性をみるために，Ul（－）m癌にリンパ節転移がどのくらいみられるか，その特徴は何か，を調べた．Ul（－）m癌リンパ節転移例は6例で，全早期胃癌（1,906例）の031％，m癌の0.6％にあたる．形態は隆起型2例，平坦型（Ⅱb）1例，陥凹型3例，組織型は分化型4例，未分化型2例で，これらに共通と言える特徴はなかった．ただ病巣の長径は全例が2.Ocm以上で，これが唯一の共通の特徴と言える．以上の結果から，現在の早期胃癌に対する内視鏡的治療の適応とされるものに，大きな矛盾はみられなかった．

　To evaluate the validity of indication for endoscopic local resection of early gastric cancer, it is very important to analyze patients with lymph node metastasis associated with mucosal cancer without ulcer or ulcer scar. There were 6 cases with lymph node metastasis in 1,906 early gastric cancers (0.31%) and 1,015 mucosal cancers (0.6%). They were 2 type Ⅰ, 1 type Ⅱb, 1 type Ⅱa＋Ⅱc, 1 type Ⅱb＋Ⅱc and 1 type Ⅱc early gastric cancers. All of them were larger than 2 cm in size. However, there were no significant differences in the location, histopathological findings and prognosis of the lesions. Therefore, a non-ulcerative gastric mucosal cancer less than 2 cm in size could be resected endoscopically.