噴門部癌のX線診断に関する研究―陥凹性早期胃癌を中心に

Studies on X-ray Diagnosis of Gastric Carcinomas in the Esophago-Cardiac Region

　近年，X線検査・内視鏡検査の進歩により胃癌の診断能は著しく向上し，5mm以下の早期癌でも条件が良ければ容易に診断されるところまできている．しかし，噴門部に関しては長い間，その診断能は他の部位に比べて低迷してきたが，最近造影剤の改善や撮影装置の改良が進み，噴門部の微細所見の描写も十分可能になりつつある．この段階で噴門部の診断理論も改めて見直してみる必要があると，思われる．われわれは1978年以後，噴門部の診断について検討を行い，早期癌の発見に努めてきた．この間に発見された陥凹型早期癌を対象に，噴門部特に食道開口部近傍におけるX線診断に必要な基礎的検討を行ったので報告する．

　1. The basic study for x-ray diagnosis of early gastric cancer of the depressed type in the cardiac region was made.

　2. Eight cases of early gastric cancer of the depressed type and a case of IIc-like advanced cancer of less than 3 cm in diameter were investigated for this purpose.

　3. X-ray findings of the esophago-gastric orifice were classified into four types for convenience and the esophagocardiac junction was identified radiographically (Fig. 1).

　4. The upright posterior-anterior projection, the half-standing prone right anterior oblique and the half-standing supine left anterior oblique ones were indispensable in routine x-ray examinations to detect the early gastric cancer of depressed type in the cardiac region.

　5. The macroscopical and pre-operation radiological findings of the early gastric cancer of the depressed type in the cardiac region veered emonstrated in some cases.