噴門部Squamo-columnar junctionの微小早期胃癌の1例

A Minute Early Gastric Cancer at the Squamo-columnar Junction of the Cardia

　X線・内視鏡の診断技術の進歩により，胃病変の診断においては微細病変を診断するという領域に入ってきているが，上部胃癌，特に噴門部の癌は進行癌が大多数であり，早期癌の数が少ないのが現状である．最近我々は，噴門部のsquamocolumnar junctionの10×13mmのⅡa型微小早期胃癌を経験したので報告する．

　With recent progress of diagnostic techniques, early cancers of the stomach have been easily discovered, but cancer of the cardia is rarely seen in early phase, majority have been detected in advanced stage.

　We have reported a case of minute early cancer at the squamo-columnar junction of the cardia.

　The man aged 63 had been complaining of soft stool, but there was no epigastric distress. On July 12, 1973, an X-ray examination of the upper GI-tract was performed at our hospital, and at that time a minute polypoid lesion was disclosed at the cardia. Esophagofiberscopy also revealed a minute elevated lesion at the cardia, and a few biopsy specimens were taken from it. The lesion was histologically diagnosed as adenocarcinoma tubulare.

　On October 12, esophagocardiectomy was performed. In the resected stomach, a slightly elevated carcinoma (Type Ⅱa) measuring 13×10 mm was situated at the squamo-columnar junction through the lesser curvature site, and was almost limited in the mucosa. However, a few malignant tubuli infiltrating the submucosa were microscopically recognized at one point.

　Early gastric cancer of the squamo-columnar junction is very rare, and only two cases of Type Ⅰ and Ⅱc has been reported. We have referred to the literature of early cancer of the cardia, and briefly discussed histogenesis of our case.