小さなⅡa型早期胃癌の1例

Minute Type Ⅱa Early Carcinoma of the Stomach Report of a Case

はじめに

　最近における胃集団検診の普及は，目ざましいものがあり，多数の胃癌が，その症状発現の以前に発見されるようになってきている．

　特に，比較的自覚症状の少ない，隆起性病変の発見例数の増加に伴ない，Ⅱa型早期胃癌と異型増殖（ATP）が，診断上，あるいは病理組織学上の問題点として，取り上げられてきている．

　今回供覧する症例も，千葉県対ガン協会で施行した胃集団検診で発見され，Ⅱa型早期胃癌か，異型増殖かで問題となった小病変の1例である．

　Type Ⅱa mucosal carcinoma of the stomach, measuring 9×6 mm, detected by gastric mass survey, is reported.

　Because of the wide spread of gastric mass survey in Japan, there have been increasing numbers of reports of elevated lesions, and lesions hard to discriminate whether they are of atypical epithelium or of type Ⅱa early gastric cancer are also more frequently reported.

　Regarding minute protrusions smaller than 10 mm in their size, it should be emphasized that the difference in gross appearance between atypical epithelium and type Ⅱa early cancer is so slight that the radiologic and endoscopic differential diagnosis is very clifiicult.

　As the developmental process from atypia to carcinoma has not been made clear yet, accumulation of correct information on the nature of the minute elevated lesion by means of x-ray, endoscopy and biopsy including follow-up examination shall be of great help in clarifying the process and for the differential diagnosis of this variety of early gastric cancer.