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Stomach and Intestine(Tokyo) Volume 19, Issue 7 （July 1984）

胃と腸 19巻7号（1984年7月発行）

Japanese English

今月の主題早期胃癌の再発死亡例をめぐって

主題

診断学的立場からみた早期胃癌再発死 Roentgenographic and Endoscopic Observations of Recurrence Death in Early Gastric Cancer 吉田茂昭 ¹ , 森山紀之 ² , 斉藤大三 ¹ , 北岡久三 ³ , 廣田映五 ⁴ S. Yoshida ¹ , N. Moriyama ² , D. Saito ¹ , H. Kitaoka ³ , T. Hirota ⁴ ¹国立がんセンター内科 ²国立がんセンター放射線診断部 ³国立がんセンター外科 ⁴国立がんセンター研究所病理 ¹Department of Internal Medicine, National Cancer Center Hospital ²Diagnostic Radiology, National Cancer Center Hospital ³Surgery, National Cancer Center Hospital ⁴Pathology, National Cancer Center Hospital pp.763-771

発行日 1984年7月25日 Published Date 1984/7/25

DOI https://doi.org/10.11477/mf.1403109519

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Abstract 文献概要
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要旨　早期胃癌再発例34例を診断学的な立場から検討した．これらの主たる再発形式は血行性転移，殊に肝転移であり，この場合，多くのものが術前X線・内視鏡像上，進行胃癌様の所見を示すことから，あらかじめその高い生物学的悪性度を予測することが可能である．これに対し，血行性転移以外のものは，頻度も少なく，また病巣も通常みられる潰瘍性の陥凹性早期癌であること以外に特徴像は得られず，不良な予後を予測することは困難である．

　Authors studied the recurrence death observed in 34 cases of early gastric cancer from the diagnostic standpoint and the results obtained were as follows:

　1) The main mode of recurrence was haematogenous metastasis, especially liver metastasis, the lesions of which were recognized clinicopathologically in many cases as cancer in aged patients and differentiated type of tubular adenocarcinoma. Also, the antral lesions of elevated type and those without peptic ulcerative findings were frequent. Roentgenographically and endoscopically most of these lesions were seen as advanced gastric cancer because of the deep excavation or massive elevated component located within or around the lesions.

　2) On the other hand, cases of recurrence other than that of haematogenous metastasis were few in number with poor characteristic appearance unlike the ones mentioned above. In addition, these lesions were often recognized as typical appearance of depressed type of early gastric cancer with ulcerative findings by roentgenographic and endoscopic examinations.

　3) The degree of malignancy classified in the preoperative roentgenographic and endoscopic findings, it was clearly correlated with the possibility of recurrence, and authors were able to detect that ten percent of cases with advanced cancer-like appearance may recur. On this occasion, the lesions in the antrum included higher possibility than those located in the other sites of the stomach. In case of lesions with common appearance of superficial type of early gastric cancer, the possibility of recurrence, although few, can not be denied if there had been ulcerative findings with clear malignant appearances.

　On the othe hand, in case of superficial lesions with unclear ulcerative findings, not restricted to elevated or depressed types, authors have not found any recurrent cases up to this time.