家族性大腸ポリープ症の胃病変

Gastric Lesion of Familial Polyposis Coli

　家族性大腸ポリープ症（以上FPCと略す）は主に大腸に限局して無数の腺腫がびまん性に発生し，しかもそれらが高率に悪性変化し，メンデルの常染色体性優性遺伝法則に従って子孫に遺伝する疾患と考えられている．大腸の病変が極めて特異な形態を示すために，諸家の関心は専ら大腸ポリープに向けられてきた感があったが，最近，胃，歯牙や骨などに随伴性病変が高率に発見されるようになり，それらについての報告も増加しつつある.

　さきに著者らはFPCの胃病変について報告したが，今回はその病理組織学的面を中心として述べてみたい．

　Gastric polyps of patients with familial polyposis coli are a unique type of polyp characterized by multiple occurrences. This paper reports 16 cases of familial polyposis coli in 6 different unselected families.

　Clinical studies such as roentgenogram and endoscopic examinations were carried out in 11 cases, the resected stomach was examined in 2, and autopsy material was used in 3.

　Elevated lesions were found in the stomachs of 11, but those in an autopsied case with gastric cancer were disclosed to be intra- and sub-mucosal infiltration of neoplastic cells, So gastric polyps were found in the stomachs of 10 (62.5％). It is a much higher incidence than in the results of a nation wide survey conducted in June, 1972, which revealed descriptions on gastric polyps in 9 of 88 cases (10％).

　Those elevated lesions are diffusely scattered over the gastric mucosa, or located either on the antrum or on the fundus, Histological examination reveals hyperplasia of foveolar epithelia and cystic dilatation of glandular lumina on the one hand and appearance of atypical epithelium on the other. Differences on histologic features may be due to location of elevated lesions, age of patients, to which family patients belong, and so on.

　We believe that this disease is not necessarily localized to the large intestine, and that the absence of gastric polyps in other case reports is due probably to insufficient examination of the stomach. We also believe that gastric polyps in patients with familial polyposis coli should be followed up in order to throw light on correlation between carcinoma and ATP, Ⅱa subtype and Type Ⅲ and Ⅳ polyp.