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Stomach and Intestine(Tokyo) Volume 6, Issue 9 （August 1971）

胃と腸 6巻9号（1971年8月発行）

Japanese English

今月の主題幽門部（pyloric portion）の病変

主題

胃下部の悪性病変 Malignant Lesions in the Antrum 高木国夫 ¹ Kunio Takagi ¹ ¹癌研究会附属病院外科 ¹Dept. of Surgery, Cancer Institute Hospital pp.1149-1156

発行日 1971年8月25日 Published Date 1971/8/25

DOI https://doi.org/10.11477/mf.1403111624

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Abstract 文献概要
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　胃下部は幽門部，前庭部，幽門洞等の名で呼ばれるが，この部は胃の上部，中部に比して正常でも狭く，ここに発生する病変は他の部よりも各種検査の適応が不充分である．とくに幽門輪に近接した部は，特別に幽門前部（prepyloric region）と呼ばれているが，明らかな定義はないようである．

　すなわち，胃下部は，内腔が狭く診断が困難な場合もあって，この部に発生する病変，とくに悪性病変について，胃上部，中部の病変に比較してみたい．

　Malignant lesions in the lower part of the stomach-lower part based on general rules for the gastric cancer study in surgery and pathology have been studied with emphasis laid on their localizations. Gastric cancer, the most frequent neoplasm of the stomach, was most often seen in the lower part of the stomach, and macroscopically, Borrmann types Ⅲ and Ⅳ were most frequent. As compared with cancer nests in the other parts of the stomach, those in the lower part mostly measured from 4.0 to 7.9 cm in the greatest diameter. Early gastric cancer is known for its highest incidence in the middle part, and that in the lower part is distinguished for its frequency in Ⅱa type. The lesions were mostly 2.0 to 3.9 cm long. Protruding type of early cancer lesion was seldom more than 6.0 cm in the largest diameter, while 8 out of 59 cases of depressed type measured more than that. Studies on benign ulcer associated with depressed type early caner have shown that Ul-Ⅳ type ulcer was less frequent as compared with that in the other parts of the stomach.

　Minute carcinomas less than 1cm in diameter were most often seen in the lower part, especially those Ⅱc that were less than 5mm in diameter.

　Of 16 cases of gastric sarcoma encountered by the authors, that in the lower part was seen in 5 (32%). Here were also found 3 malignant lymphomas, one each of leiomyosarcoma and malignant neurilomoma. Mostly they were locatad in the greater curvature side.

　The study has also been made in the literature concerning intragastric metastasis of melanoma together with localization of gastric carcinoid.

　Atypical epithelium, now often discussed as a border-line lesion between malignancy and benignancy, was also seen in the lower part of the stomach, and especilally protruding variety was more frequent here.