スキルスの臨床

CLINICAL ASPECTS OF SCIRRHUS

Ⅰ．はじめに

　近年，早期胃癌の診断学が一応確立され，研究の焦点が，より微細な早期のものに向っているとき，一方では前回の検査で異常を指摘できなかったにも拘わらず，半年前後の短期間に，胃癌の中でも予後の悪いBorrmann4型のSkirrhusに進行した症例の経験は，今日なおあとをたたない．これの対策として，Skirrhusの臨床診断，ひいては早期診断について研究することもまた，目下の急務であろう．

　Diagnostic study for the early gastric cancer has been accomplished to some extent. But on the other hand, a Borrman 4 type scirrhus is especially hard to be recognized in its early stage. To prevent this, clinical and early diagnoses are studied. At first, concept of scirrhus is referred to historically and histologically. Then a macroscopic finding is mentioned using 17 cases in our Institute. It is difficult, in the case of scirrhus, to relate early gastric cancer with advanced cancer. Many researchers emphasize the shallow cancerous erosion as developmental ground of scirrhus. How to diagnose scirrhus clinically is described. X-ray and endoscopical findings and differencial diagnosis are explained in detail using the cases developed in the Institute. Typical and early stage scirrhus are presented with its X-ray photographs and endoscopical findings.

　Finally, how to find scirrhus in its early stage is mentioned.