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Stomach and Intestine(Tokyo) Volume 25, Issue 12 （December 1990）

胃と腸 25巻12号（1990年12月発行）

Japanese English

研究

胃癌の粘膜下組織への初期浸潤様式 The Mode of Initial Invasion of Gastric Mucosal Carcinoma to the Submucosal Layer 篠原直宏 ¹ , 望月真 ¹ Naohiro Shinoharal ¹ , Makoto Mochizuki ¹ ¹自治医科大学病理 ¹Department of Pathology, Jichi Medical School キーワード：胃癌の初期粘膜下組織浸潤様式 , 胃癌の発育・浸潤 Keyword: 胃癌の初期粘膜下組織浸潤様式 , 胃癌の発育・浸潤 pp.1469-1475

発行日 1990年12月25日 Published Date 1990/12/25

DOI https://doi.org/10.11477/mf.1403111769

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Abstract 文献概要
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要旨　ヒト胃癌における粘膜下組織浸潤部が2mm以下の初期粘膜下組織浸潤巣69病巣について，癌細胞の粘膜筋板通過様式を病理組織学的に検討した．初期粘膜下組織浸潤様式は4種類あり，①脈管周囲型（癌細胞が粘膜筋板を貫く脈管周囲の組織間隙を経て粘膜下組織へ達するもの）が最も多く，全体の約70％を占める．次いで，②脈管侵襲型（脈管侵襲によるもの），③破壊型（粘膜筋板の破壊・断裂によるもの），④異所性腺管型（異所性腺管の周囲組織を通って粘膜下組織へ達するもの，未分化型癌のみ）がある．3～10mmの粘膜下組織浸潤でも，原則的には2mm以下の粘膜下組織浸潤様式が適用でき，ほかに浸潤様式不明のものがある．頻度は脈管周囲型浸潤が最も多いが，破壊型が増加する傾向がある．

　The way cancer cells infiltrate from the gastric mucosa to the submucosa was examined histopathologically. This was done by means of serial sections of 69 early gastric carcinomas, whose largest diameter in the submucosal layer was less than 2 mm. Of the 69 carcinomas, 35 were histologically of mucocellular pattern or anaplastic adenocarcinomas that belonged to the category of undifferentiated carcinoma (UCA). The remaining 34 were tubular adenocarcinomas that belonged to the category of differentiated adenocarcinoma (DCA).

　The mode of initial invasion of the gastric mucosal carcinoma to the submucosal layer was categorized into four types (Fig. 1, Table 2): 　(1) Perivascular type (Fig. 2): Carcinoma cells infiltrating to the submucosa along the perivascular spaces of the small vessels through the muscularis mucosa. This type was the most frequent process found in cancerous submucosal infiltration (24/35 UCA, 25/34 DCA).

　(2) Intravascular type (Fig. 3): Carcinoma cells infiltrating to the submucosa by invasion of the vessels (7/35 UCA, 5/34 DCA).

　(3) Destructive type (Fig. 4): Carcinoma cells infil-trating to the submucosa with destruction of the muscularis mucosa (2/35 UCA, 4/34 DCA).

　(4) Heterotopic glandular type (Fig. 5): Carcinoma cells infiltrating to the submucosa in association with heterotopic glands. This type was found exclusively in undifferentiated carcinomas (2/35 UCA, 0/34 DCA).

　Additionally, 75 early gastric carcinomas measuring 3 to 10 mm in diameter in the submucosal layer were also examined histopathologically. The above categorization was applicable in general to these carcinomas, also.