切除胃標本における日本住血吸虫卵の介在とその意義について

Relationship between Development of Cancer or Ulcer and Parasitic Eggs of Schistosomia Japonicum in Gastrectomized Specimen

　日本住血吸虫は古くは広島，岡山，山梨，佐賀，福岡のほか，茨城，千葉，埼玉県などにも分布していたが，現在では山梨県の甲府盆地および広島県片山地方，福岡，佐賀の両県にまたがる筑後川流域のみにみられ，他の地方ではかげをひそめている．

　日本住血吸虫症の病原体である日本住血吸虫は腸管壁の細小血管に産卵するため，本虫卵が腸管壁に寄生して外科的障害を惹起したとの報告はかなり多く，腸管，特に直腸，虫垂壁，回盲部，S状結腸壁に日本住血吸虫卵（以下日虫卵と略す）の介在をみたとの症例報告は数百例を数える．日本住血吸虫は門脈に寄生する関係から，その分枝領域にある胃および十二指腸にも当然虫卵の介在は起こりうるが，人体でははなはだ稀で，胃・十二指腸潰瘍および癌腫に日虫卵の介在をみたとの記載は表1に示すように，宮川5例¹⁾，古賀1例²⁾，矢野1例³⁾，佐藤1例⁴⁾，古賀3例⁵⁾，鈴木2例⁶⁾，土方1例⁷⁾，大野1例⁸⁾，川久保1例⁹⁾の計16例を算するに過ぎない．

　During the 13 years May 1957 to April 1965 542 cases of gastric ulcer and 444 of gastric cancer, confirmed as such later by histopathological investigations, underwent partial or total gastrectomy. The eggs of schistosoma japonicum were found in 21 cases (2.1%) out of the total of 986.

　The male by far predominated over the female: male, 16 cases, female, 4. Classified according to the varieties of gastric diseases, gastric cancer amounted to 17 cases; gastric ulcer, 4. All of cancer cases belonged to adenocarcinoma histologically.

　Gross observation of the liver has shown that findings of liver cirrhosis have been observed in 4 cases of gastric cancer and in 1 of gastric ulcer.

　The eggs of schistosoma japonicum have been mostly found in the submucosal layer with a few in the mucosal stroma. Eggs have been found in some of lymph nodes as well.