早期胃癌類似進行癌の検討―進行胃癌類似早期癌と比較して

Early Stomach Cancer Resembling Advanced Cancer: Comparison with Advanced Stomach Cancer Resembling Early Cancer

要旨　早期胃癌に対する縮小手術や内視鏡的切除療法が普及してくるにつれて，早期胃癌であることを正しく診断することがますます重要となってきた．われわれは，切除標本上で肉眼的に早期胃癌と診断した進行癌（準早期深達癌）を“早期胃癌類似進行癌”とし，これと肉眼的に進行胃癌と診断した早期癌（準進行表在癌）を臨床病理学的に比較検討し，次の結果を得た．上部，長径4cm以上，陥凹型，未分化型の癌，若年者の場合には，深達度を浅く見積もってもpm以上の深いものがある．一方，中下部，長径4cm未満の癌，男性の場合には深達度を深く見積もっても浅いものがある．双方とも予後は良好で，臨床上の問題は少ない．

　It has increasingly become important to correctly diagnose “early gastric cancer” as endoscopic surgery and limited surgery have been developed.

　In order to help diagnose more accurately “early gastric cancer”, we carried out clinicopathological study on advanced gastric cancer regarding macroscopical underestimation (semi-early advanced cancer) and overestimation (semi-advanced early cancer).

　The results were as follows. The depth of invasion tended to be underestimated in younger patients with cancer which was located in the upper stomach, 4 cm or larger in size, depressed and poorly differentiated type. On the other hand, the depth of invasion tended to be overestimated in male patients with cancer which existed in the middle or lower part of the stomach, 4 cm or less in size. Both groups of the subjects exhibited good prognosis posing no clinical problem as far as the current therapeutic technique are concerned.