胃集検で発見された胃潰瘍―頻度と性質

Ulcer of the Stomach Detected at the Mass Screening

　胃集検が，胃の悪性病変の早期発見に貢献した実績と意義は，高く評価されて良い．

　しかし一方，胃集検で発見されている胃疾患の中で，良性疾患の発見頻度は胃癌よりはるかに多く，早期発見，早期治療によって人類社会へ大きく貢献している．

　Gastric ulcer is detected in the mass screening approximately 10 times as often as gastric carcinoma, but its positive rate is only half of that in the outpatients' clinic in the hospital. On the other hand, the rate of ulcer scar in healed stage is twice as many as in the out-patients' clinic. The size of active open ulcer measured on the x-ray film was less than 0.5 cm long in 45.2 per cent in the cases of mass screening, on the average smaller than that seen in the out-patients' clinic. Frequency of symptom-free ulcer was especially high among occupational groups.

　The shape of gastric ulcer in the mass survey was almost the same as that seen in the out-patients' clinic. Possibly because of indirect radiography which dispensed with effervescent tablets, the rate of ulcer detection was low on the posterior wall of the corpus.

　Criteria of judgement in interpretating indirect radiographs have been divided into five groups in order of accuracy.

　Ⅴ……A lesion is definitely confirmed.

　Ⅳ……A lesion is suggested by the findings.

　Ⅲ……An abnormal finding is seen, but it is not certain whether it is due to a lesion.

　Ⅱ……Judgment is impossible because of poor exposures.

　Ⅰ……No abnormal finding is seen.

　The rate of ulcer detection in each of these groups is: 36.9 per cent of open ulcer in Ⅴ, 17.1 per cent of in Ⅳ and 6.4 per cent in Ⅲ. Of 313 detected open ulcers, 19.7 per cent were seen in Ⅴ, 50.5 per cent Ⅳ and 29.7 per cent in Ⅲ. Ulcer scar was seen in 2.0 per cent in Ⅴ ; in 47.4 per cent in Ⅳ and in 50.6 per cent in Ⅲ. From the group Ⅲ, which is not decisive for diagnostic criteria, gastric cancer was found in 0.6 per cent. Moreover, two out of eight cases of gastric cancer proved to be early ones, and of 27 cases of early gastric cancer as determined by four direct exposures, 33 per cent belonged to Ⅲ. Together with the fact ulcer scar is most often found in Ⅲ, analysis and evaluation of the group Ⅲ is a problem that should be solved in future.