いわゆるⅡb病変の内視鏡的肉眼的ならびに組織学的所見の比較検討

A Comparative Study of Histopathology, Macroscopy and Endoscopy on Type Ⅱb Early Gastric Carcinoma

　いわゆるⅡb病変の肉眼的な性状については，X線学的，内視鏡学的あるいは病理組織学的な立場から種々の検討が行なわれているが^1)～27)，なお不明な点が残されている．Ⅱb病変の性状は各検査法別に各論的に詳細に吟味されているが，各部門相互の所見の相関に留意した報告は比較的に少ないように思われる．

　われわれはⅡb病変の病理組織標本による断面像，摘出標本肉眼所見および内視鏡所見それぞれについて検討するとともに，各部門の所見を比較検討することにより，Ⅱb病変の肉眼性状の解明をはかり，2，3の知見を得たので報告する．

　Based upon the histological observation of 18 cases (20 lesions) of gastric carcinomatous mucosa without niveau difference from non-carcinomatous area, gastro-endoscopical pictures and gross findings both of fresh and postfixation materials were compared retrospectively.

　Endoscopically about half of these lesions showed slight reddening, but in the other half color of the mucosa was quite similar to the non-carcinomatous mucosa. The surgical materials in fresh state showed almost the same color as in endoscopic pictures. In 83% of the endoscopic pictures, fine abnormal configuration such as irregularity was seen. In fresh specimens, surfaces of type Ⅱb early gastric cancer showed indistinctness of gastric area grooves. In fixed specimens, these same lesions appeared enlarged and exhibited irregularities in the gastric areas.

　These surface abnormalities correlated with the grade of cancerous destruction of the foveola and gastric area, and with the density of cancer cell infiltration. Most of them reflected the gastroendoscopic findings.