切除胃よりみた若年者胃癌

Gastric Cancer in the Young: A study of 16 resected cases

　近年胃癌の診断技術向上にともない，早期胃癌の発見率が著しく向上し，外科的にも胃癌根治手術の方法も著しい進歩をとげた．とくに胃癌に対するリンパ節廓清術の確立は最右翼でその予後は驚くべき好成績を得ている，しかしこれを年齢別，特に若年者胃癌を取り上げてみると必ずしも上記のように良い成績とはいい難い．その理由は発生数が少なく，しかも年齢が若いということで普段から健康管理がおろそかになっていること，ことに日本において急速な発展を遂げた胃の集団検診の対象外になっているということで胃癌が見逃がされ，若い命を断っているのが現況^10)16)22)である．

　若年者胃癌について1848年Dittrich²⁴⁾が報告して以来多数の報告が見られるが，本邦では，1894年滝口¹⁾の25歳の男子の例が最初の報告であるとされている．最年少例の報告は，1859年Wiederhofer²⁵⁾の生後16日の新生児であり，本邦では1964年三浦¹¹⁾の報告した1歳11カ月の女児である．ここではわれわれも若年者胃癌の年齢を満30歳未満¹⁴⁾²⁰⁾と仮りに定めた．

　The rate of gastric cancer in the young adults below the age of 30 was naturally low (16 cases, 2.1 per cent) in a total of 761 gastric resection for cancer. The duration of symptoms up to the surgical correction was long-2 years and 10 months on an average. Preoperative general condition of the patients was mostly good. Macroscopically, the rate of depressed types was higher than that of protuberant varieties. Association of ulcer within cancer focus was seen in high rate. Histologically, poorly differentiated adenocarcinoma was predominant. The primary sites of cancer were equally divided in A (lowe portion) and M (middle portion). Even when cancer was in advanced stage, curative resection showed better results than in older age groups. Prognosis was accordingly better. Previous history of gastric cancer was confirmed in 26.3 per cent among the relatives of the first and second degrees.

　It is true that gastric cancer in the young under the age of 30 is comparatively rare. Its characteristics are not much different from those of other age groups. However, since the young people, believing that they are still not of ‘cancer generations', are apt to forego necessary examinations; and lest the doctors themselves should overlook cancer all too easily in the face of data obtained by the examinations the young people took the trouble to undergo, we do deem it of great importance to have periodic check-up of the stomach in the young by means such as gastric mass survey.