胃・大腸・胆嚢早期癌の肉眼形態の比較

Comparative Morphological Study on Early Carcinoma of the Stomach, Large Intestine and Gallbladder

要旨　過去4～6年間に外科的切除材料に発見された，早期胃癌1,195病変，早期大腸癌104病変，早期胆囊癌44病変を用いて（微小癌を除く），各臓器間での肉眼形態の差およびそれが生ずる原因を検討した．Ⅰ型部を有する癌の頻度は，大腸に最も高く（53％），次いで胆囊（30％），胃（8.1％）の順であった．低い隆起型を持つ癌の頻度は，胆囊（46％），大腸（39％），胃（18％）の順で，Ⅱb型癌のそれは胆囊に極めて高かった（25％）．陥凹型癌の頻度は，胃に有意に高く（57％），大腸で1.0％，胆囊では0％であった．大腸では，胃や胆囊に比べて，腺腫内癌の頻度が高かった．胆囊では，特に，随伴性Ⅱb型が高頻度にみられた（39％），これら臓器での，早期癌の肉眼形態の差は，癌の組織型，癌の発生母地，癌の存在環境（胃酸，結石，蠕動，臓器の壁構造）から生ずると考えられた．

　It is our aim to find morphological differences of early carcinomas and their causes between the stomach, the large intestine and the gallbladder. The number of the early carcinoma except for microcarcinoma less than 5mm in the largest diameter was 1,195 in the stomach, 104 in the large intestine and 44 in the gallbladder.

　The incidence of the carcinoma containing I type carcinoma was highest (53%) in the large intestine, 30% in the gallbladder and 8% in the stomach, while that of Ⅱa type carcinoma was 39%, 46%, and 18%, respectively. Ⅱb type carcinoma occurred as high as 25% in the gallbladder.

　Ⅱc type carcinoma was significantly high (57%) in the stomach and very low (1%) in the large intestine or null in the gallbladder.

　The difference of macroscopic type of early carcimomas in each organ seems to arise from the difference of incidence of histological type of carcinoma and carcinoma in adenoma, as well as the difference of environment (gastric acid, stone, peristalsis, structure of organs) of the carcinoma.