胃潰瘍に対する胃直視下生検の意義

Significance of Biopsy under Direct View in Gastric Ulcer

はじめに

　胃潰瘍の直視下生検の意義について述べるのはけっして楽ではない．実際，直視下生検法の意義がまず喧伝されたのは，胃癌の直接診断ことに早期冑癌の診断においてであったからである．

　本邦における胃疾患診断学の進歩は，X線検査，内視鏡検査の機種の開発と改良，手技の進歩に負うところが多いが，そのなかでも世界にさきがけた生検ファイバースコープの開発の占める位置は著しく高い．

　X線検査または内視鏡検査法はいかに習熟しても，あくまで検査方法としては間接診断法である．これに対して直視下生検法は，直視下細胞診法とともに，積極的な直接診断法であり採取された粘膜片が小さくとも，一応組織のレベルで診断されることを銘記しなければならない．

　本文では，胃潰瘍の診断の場での直視下生検法の果す意義ないし役割を，以下の項目によってまとめてみた．

　The importance of biopsy under direct vision of gastric ulcer is discussed regarding to the discrimination between it and early gastric cancer. This implies clinically a very important subject. As an aid to elucidate it, 2 cases of shallow depressed variety of early gastric cancer, often apt to be overlooked, are presented. Both have been confirmed as such by biopsy under direct view.

　It also is described that biopsy under direct vision is not only of great account in the diagnosis of each stage of gastric ulcer or “zonal gastritis” but it is expedient as well in predicting the final outcome of the disease. An approach to the elucidation of pathognomy of gastric ulcer has now been made feasible by it.

　Biopsy under direct vision is of great significance in the diagnosis of gastric ulcer, and this procedure, if properly utilized, can further the possibility of medical management under direct vision of gastric ulcer.