胃腺窩上皮化生（胃上皮化生）

Duodenitis and Gastric Epithelial Metaplasia

要旨　胃上皮化生からみた十二指腸炎について臨床的，病態生理学的検討を行った．十二指腸炎における胃上皮化生の出現率は高く，特に萎縮が軽く酸分泌が高い十二指腸粘膜に出現する率が高い．内視鏡下にメチレンブルーを撒布すると不染部として観察される．組織学的，機能的にも本来の胃表層上皮と類似していることがわかった．特に強い粘液代謝能を有していることから，胃上皮化生は十二指腸粘膜の防御因子的役割を果たしていることが示唆された．

　We have conducted endoscopic, stereoscopic, and autoradiographic studies of gastric epithelial metaplasia appearing on the duodenal mucosa along with duodenal ulcer or duodenitis, and we have investigated its clinical significance and functions.

　Endoscopically, gastric epithelial metaplasia is often recognized in those regions where redness, erosive and polypoid changes are present.

　As a methylen blue solution is unable to stain gastric epithelial metaplasia, it is conceivable that the absorption function may have been lost or deteriorated.

　Further, it was learned by means of PAS staining and ³H glucose autoradiography that, similar to the original gastric epithelium, gastric epithelial metaplasia indicates a pattern of strong mucosal metabolism.

　Clinical investigation revealed that in cases manifesting gastric epithelial metaplasia, there is a tendency for there to be only a slight degree of atrophic gastritis despite a high degree in the function of gastric acid.

　Based on the above findings, we judged that the pattern of development seen in the emergence of gastric type epithelium in duodenitis is the same as that in duodenal ulcer, and that metaplasia emerges from the regenerated epithelium in the healing process of mucosal defects such as erosion, etc. Such gastric type epithelium seems to play a role in protecting mucosa from attacking factors such as gastric acid, etc.