長期間経過が観察された早期胃癌の1例

Ⅰ．まえがき

　胃癌の診断技術の向上に伴い，病変部を忠実に表わしたX線あるいは内視鏡の記録による経過が，胃癌の発育を知る一つの材料として重要になって来た．我々は幸か不幸か，患者の都合により肉眼的に癌と診断し得る像を得てから，3年9力月と言う期間の後，尚早期胃癌であった症例を経験し，その経過が主として内視鏡にて追求されたので報告する．

　Recently, with progress inmethods of diagnosis of gastric cancer, many cases which were shown to be in the clinically proliferating state of gastric cancer have been reported. This is a reportof a case of cance that cotinued to exhibit the early stage of gastric cancer for threeyears and nine months after macroscopic diagnosis of gastrc cancer.

　The patient was a forty-one year old housewife who was diagnosed in January 1963 as early gastric cancer (Ⅱc+Ⅲ) in the anterior side of the greater curvature of the lower gastric body by X-ray and gastrocamera examinations. We continued investigating this case mainly through the gastrocamera, as she refused surgery, and in September, 1966, after three years and nine months of observation, gastrectomy was performed.

　Our sequential study by endoscopic examination was as follows. A year after the diagnosis of this case as gastric cancer, the ulcer in the concaved lesion contracted insize and there were no changes inother findings. Two years and four months later, the ulcer enlarged in size and the concaved lesion was spreading and, furthermore, by the deformity and hardening of the lesion we suspected advanced cancer. Three years and nine months later, her case was diagnosed as advanced cancer.

　The histological findings indicated a signet-ring cell type, and considering both her age and histological findings, the cancer seemed likely to be a rapid advancing type.

　Although individual differences should be taken into consideration, it is noted that there is a very slow growing type of cancer and, in addition, a malignant ulcer as the base of cancer could contract in size.