腸カルチノイドの病理

Gastrointestinal Carcinoid Tumors of Japanese: Incidence and Characteristics Based on Anatomical Classification, with Special Reference to Difference between Carcinoid Tumor and Endocrine Cell Carcinoma

要旨　消化管カルチノイド腫瘍194例220個を検討した．本腫瘍の部位別発生頻度は，直腸（45％），十二指腸第一部（21％），胃（13％）に高く，虫垂（11％），小腸（3％）に低いことが特徴であった．本腫瘍の解剖学的部位別分類を作成し，その部位別の特性を示した．消化管内分泌細胞腫瘍は，低悪性度のカルチノイド腫瘍と高悪性度の内分泌細胞癌とに大別された．

　220 carcinoid tumors (CD) of 194 cases and 8 endocrine cell carcinomas (ECC) of Japanese patients were examined.

　In Japanese population, the rectum is the most favorable site of occurrence of CD and the incidence of CD of each site was as follows; stomach: 13％, duodenal 1st portion: 21％, duodenal 2nd portion: 7％, jejunum: 1％, ileum: 2％, appendix: 11％ and rectum: 45％.

　According to the anatomical classification, CD of duodenal 1st portion are characterized by gastrin-family cells immunohistochemically and intestinal G cell ultrastructurally, CD of duodenal 2nd portion by somatostatin cells and D cells, CD of appendix by peptide YY cells and D1 and/or L cells, and CD of rectum and colon by PP, PYY and glicentin cells and D1 and/or L cells. Gastric argyrophil CD were characterized by ECL, D1 and/or X cells but their hormonal substance remain unclear. Argentaffin CD consisted mainly of serotonin cells and ECn and/or EC₁ cells unrelated to occurring sites.

　Gastrointestinal endcrine cell tumors should be devided into CD, low-grade malignancy, and ECC, highgrade malignancy.