術前深達度診断mとしたⅡc型sm胃癌の1例

Early Gastric Cancer, Type Ⅱc, with Submucosal Invasion Diagnosed as Infiltration of m before Surgery, Report of a Case

　最近早期胃癌に対する手術の合理化が話題として取り上げられており，術前あるいは術中における深達度の判定は，リンパ節廓清範囲，程度に影響を及ぼし，手術法決定の指標となりうる問題である．

　現在までに深達度診断に関する種々の報告がみられ，ある程度の術前診断は可能であり，ある程度予後を予想しうるものである．しかし非常に判定の難しい症例も数多くあり，われわれも術前にmと診断し，術後組織診にて2ヵ所にsm浸潤をみた症例を経験したので報告する．

　The patient is 45-year-old man.

　Recently the anti-tumor immunity in the regional lymph nodes have been expected from the tumor immunological point of view, and the operative procedures for early gastric cancer have been re-investigated on the long-term follow-up for the prognosis from the statistical aspect.

　Nowadays, differential diagnosis between cancer cell infiltration of m and sm is possible to a certain extent. However, it is sometimes very difficult to differentiate small lesion of sm from the wide m of infiltration of cancer cells or the case with ulceration. Definite diagnosis of m or sm infiltration would be required by the improvement of newer technique to establish adequate operative procedures including the dissection of lymph nodes.