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胃潰瘍の疫学的諸事項の検討は古くから行なわれているが,その成績はまさに千差万別で一定の見解として理解するにはまだ程遠いと言わざるをえない.幸いわが国には胃集団検診という独得の検査方法が次第に体系づけられてきたので,この方面からのアプローチが可能となり,従来までと異った方向から疫学的全貌を把握する緒が得られるようになってきた.中でも発生頻度と発見胃潰瘍の分析成績は,検査器機とそれにたづさわるものの技術と能力によって較差が生じることは避けられないところであり,従って今回はこのような点も考慮して昭和44年度より同46年度までの最近3年間の胃集検発見胃潰瘍の分析を試みた.
検討方法と対象
検討項目としては頻度,発見胃潰瘍の性状を主とし,対象は岡山県胃集検の精検報告書より得た40歳以上の胃潰瘍の発見成績の分析を行ない,さらに某山村地域の一般住民を対象にして間接X線テレビのスクリーニングに始まり精検,治療,経過追跡に至るまで全て自験で行なった発見胃潰瘍と同じく間接X線テレビによる胃集検で全てを自験で行なった某職域の発見胃潰瘍の症例を併せて胃潰瘍の頻度,分布,大きさ等を性別,年齢別に検討しさらに職域検診と一般住民検診との間の差異について検討した.
Incidence and clinical behavior aspects of gastric ulcer including its scar have been correlated between (1) reports of thorough examination after massscreening conducted in Okayama Prefecture in the years 1969 through 1971 in persons above the age of 40 and (2) those of institutions during the same period that had done all the examinations by themselves including ulcer control, with people in occupational groups and people in general in certain areas as the objects of their study.
Results : ―
1. Mass screening of the stomach was done in Okayama Prefecture in 142, 473 persons in the course of three years. Incidence of gastric ulcer detected thereby differed from year to year, ranging between 2.3 and 3.19 per cent.
2. Gastric ulcer in occupational groups was identified satisfactorily. The positive rate of ulcer detection for three years ranged from 2.31 to 2.63 per cent. The ratio of male for gastric ulcer was about 10 : 1.
3. Gastric ulcer was found in certain areas with an average incidence of 3.47 per cent in three years, The male outnumbered the male in a ratio of 6.59 : 0.97. Ulcer scar was detected in a higher proportion than in occupational groups.
4. Study of 108 cases of gastric ulcer showed that it was located mostly at or around the gastric angle (78 cases) and in the corpus and cardia. It was seen in only a few in the antrum and pylorus.
5. The size of ulcers : in 70 cases ulcer scars were seen; in 18 cases ulcer was less than 0.9 cm long; in 16 it was 1.0~1.9 cm long and in 4 it was longer than 42 cm.
6. Of all ulcers seen in the persons over the age of 60 (12 cases), open ulcer was seen in a high rate (5 cases), located in the corpus and cardia in more than half (7 cases).
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