胃癌診断におけるルーチン検査の確かさ―X線・内視鏡検査の両面から

Accuracy of Routine Examinations of Upper Gastrointestinal Series in the Diagnosis for Early Gastric Cancer

要旨　日常臨床上実施してきたX線および内視鏡ルーチン検査の確かさについて検討した．1980年4月より1985年1月の期間に実施したX線ル一チン検査2,025例において，早期胃癌および早期胃癌疑いと診断したものは134例（6.6％）であり，その32％が最終的に早期胃癌であった．一方，同期間における内視鏡検査3,275例では105例（3.2％）が早期胃癌または早期胃癌疑いと診断されており，うち56％が早期胃癌と確診された．病理組織学的検索のなされた切除早期胃癌44例の検討からは，X線的に4例（9.0％）が描出不能であり，内視鏡的に2例（4.5％）が指摘不可能であった．以上より微小病変あるいは前壁病変，胃体上部病変，幽門輪近傍病変のルーチンワーク成績向上に努力する必要性がある．

　Accuracy of routine examinations of upper gastrointestinal series in diagnosis for early gastric cancer was evaluated in 2,025 cases with roentgenological examination (examinations being done from April 1980 to January 1985), and operated on and histopathologically proven 44 cases as early gastric cancer.

　In routine roentgenological examination, the number of cases diagnosed as early gastric cancer and s/o early gastric cancer was 134 (6.6%), of which 32% was finally confirmed as early gastric cancer. In routine endoscopic examination, the number of cases diagnosed as early gastric cancer and s/o early gastric cancer was 105 (3.2%), of which 56% was finally confirmed as early gastric cancer.

　In analysis of resected 44 cases with early gastric cancer, four cases (9%) were revealed to be overlooked in routine roentgenological examination and two cases (4.5%) in routine endoscopic examination.

　From results described above, it is concluded that diagnostic accuracy of minute lesions in the anterior wall, upper portion of gastric body and prepyloric region must be raised up in routine roentgenological and endoscopic examinations.