ごく浅いⅡc型早期胃癌の1例

A Case of Very Shallow Early Gastric Cancer

はじめに

　近年，胃X線および胃内視鏡検査の診断技術の飛躍的発達と，生検，細胞診などの併用により，早期胃癌の診断は1cm前後の病変でも術前診断がほぼ可能となってきた．しかし，一方ではかなり大きい病変でも，すうへき集中のない極めて浅い陥凹型早期胃癌の術前診断，特に病巣の拡がりの決定に困難を伴う場合がしばしばある．最近，筆者らはごく浅いⅡc型早期胃癌の1例を経験したので報告する．

　Progress in the examination techniques of diseases of the stomach has now made it possible to diagnose preoperatively an early gastric cancer of even about lcm in diameter, but sometimes it is still hard to identify a larger cancer lesion if it belongs approximately to Ⅱc. The case in this paper is a very shallow Ⅱc type early gastric cancer recently encountered.

　Both by x-ray and endoscopic examinations was the case diagnosed as Ⅱc type early gastric cancer, but in the former only rough irregularity of the areae gastricae was recognized on the posterior wall above the incisura a little toward the lesser curvature, and the extent of abnormality was hard to determine. It was the same in the gross observation of the resected stomach; it was not quite easy to indicate the site of the lesion. The diagnosis was after all confirmed by endoscopy, whic clarified the extent of this very shallow Ⅱc t early cancer by its area of discoloration along with thin white exudate over it. This case belongs to Ⅱc, but it is more of Ⅱb and its preoperative diagnosis seems to be hard to arrive at.