胃癌に関する諸問題

Some Problems about Gastric Cancer

　美しい図説のはいった日本の雑誌“胃と腸”を毎号受取り，英文の論文や抄録を興味深く読んでいるが，この雑誌の主題がいつも胃癌に関するものなので，私にも2～3の知見を述べさせてほしい．

　これまでに私は，数多くの論文を発表し，講演や学会発表も多数おこなってきたが，そのほかに，私が胃癌の早期診断について3冊の本を出版したことを御記憶のことと思う．2冊めは1956年に，3冊めは1967年に出版したものである．しかし，本文では，とくに，30年前に出版した最初の本，“Le cancer de lestomac au debut”（初期胃癌）を中心に，私の考えを述べてみたい．私の最初の本は，500ページにわたリ，630枚の図説を入れて，臨床，X線，病理の事項を述べたものである．このなかで私は，胃癌の「腫瘤型」，「浸潤型」，「潰瘍形成型」の諸型について述べた．これらの型は，日本の早期胃癌の分類である「隆起型」，「表面型」，「陥凹型」の原型ではないかと思う．

　さて，私は，ここで，胃癌の研究のなかでもとくに重要であるつぎの3つの問題，すなわち，「早期胃癌の予後」，「早期胃癌の定義」，「早期胃癌の診断法」について述べることにする．

　It is always with much interest that, receiving regularly in France this beautifully illustrated review, I read the articles written or summed-up in English. This gave me the opportunity of learning that several subjects about gastric cancer are the topic of discussions. It is the reason why I ask leave to expose some personal points of view.

　I feel obliged to excuse myself of the necessity to recall that-leaving aside hundreds of articles, lectures, congresses-I have published 3 books about early diagnosis of gastric cancer, the second in 1956, the third in 1967. But I wish to refer myself especially here to my first book, published 30 years ago, “The gastric cancer in its beginning” (Le cancer de l'estomac au debut) and less to the two more recent ones.

　This first book, published in 1939, is a study, in 500 pages and 630 illustrations, (clinic, radiology, pathology, etc.) of the various tumorous, infiltrated and ulcerated forms (Is not this classification a remote ancester of the Japanese “protruded”, “superficial” and “excavated” types ?).

　Allow me to discuss now three subjects which dominate all the works about gastric cancer: the prognosis of operated cancer, the definition of “early cancer” and the technical ways of detection.