胃集検で発見された胃潰瘍―頻度と経過

Gastric Ulcer Detected at X-ray Mass Screening: Its Incidence and Courses

　どの疾患にでも言えることだが，疾患の頻度と性状および動態を知るためには，集められた資料の条件が一定にされない限り，その意義づけは慎重であらねばならない．

　胃潰瘍についても全く同じことが言えそうである．幸い胃集検が普及されてきたため健康人中に存在する胃潰瘍について色々の情報がえられるようになったが，もし健康人中の胃潰瘍の正確な頻度と疾患の性状，およびその動態が分かれば，胃潰瘍の分析に大変役に立ちそうである．

　Mass screening of the stomach has been carried out for nine consecutive years in 2645 healthy persons in the ages 40-54. Incidence of gastric ulcer found thereby and its subsequent courses are studied here.

　The screening was done by either indirect radiograph or x-ray TV. When confirmed as harboring gastric ulcer, the examinees are then studied by direct radiograph at the next examination. We believe that by overall collection of gastric ulcers (including their scars) diagnosed at least once as such we can come as closely as possible to accurate incidence of gastric ulcer existing or developing in seemingly healthy people in the course of nine years. Its subsequent history after detection can also be well observed.

　Results : ― 　1. Of 2645 presons in the ages 40 to 54 (85 per cent are men), gastric ulcer including its scar was found in 419 persons (15.84 per cent) in the course of nine years. When only the male is counted, the positive rate goes up to 16.79 per cent. This figure far exceeds that of the national average (5.08 per cent in 1968), which was based on the results of examinations for a single year.

　2. Of 419 ulcers, those that flared up at least once numbered 162 (38.66 percent).

　3. Of 179 cases of gastric ulcer followed for more than two years after the initial diagnosis, 94 became active again once at least (52.51 per cent) while 85 cases remained healed with no manifestation of any definite niche in the interim. Of 94 recurred cases, 32 (32.04 per cent) remained in an almost healed phase for more than two years, in some for as long as eight. They are considered to represent gastric ulcers either healing easily or unlikely to recur. In the remaining 62 cases (67.96 per cent) ulcer came and went repeatedly or else niche became active again in less than two years after its complete disappearance. They include many intractable ulcers in the broader sense of the word.

　4. Of 419 patients with gastric ulcer found at the mass screening, 38 underwent surgical intervention after it. This figure goes up to 82 should 44 patients operated on before it (confirmed by questionnaires) be included. Bleeding in 35 patients and pain likewise in 35 persons account for the motives for undergoing surgical correction.