色素撒布法が診断上有効であった早期胃癌の2例

Two Cases of Early Gastric Cancer Diagnosed Effectively by Endoscopic Dye Scattering Method

　近年，早期胃癌の内視鏡診断の進歩は目ざましく，その診断技術もほぼ完成された感があるが，Ⅱb病変や微小癌の発見にはまだ充分とはいえない．特に胃X線写真，切除標本と比較して内視鏡では粘膜表面の微細顆粒状変化が把握しにくく，私共はこの難点を解消するため，井田，川井の方法による色素撒布法を試みた．今回は早期胃癌の診断に本法を併用し，有効であった2症例を供覧する．

　Two cases of early gastric cancer are illustrated here where indirect dye scattering method according to Ida, Kawai et al. was very effective in the diagnosis by determinating the nature of fine unevenness of the gastric mucosal surface. Stress is laid upon the efficiency of this method.

　Case 1 is a Ⅱc type early cancer on the posterior wall of the angle seen in a woman 38 years old. By methylene blue (MB) scattering minute granules of the surface of the gastric mucosa were seen to a far better advantage, and it was very effective in the determination of the extent of cancerous infiltration and of the depth of cancer invasion and also in the discrimination of the areas of cancer and non-cancerous part within the islet-like elevation in the Ⅱc depressive area.

　Case 2 is a Ⅲ+Ⅱc type early cancer near the anterior wall above the angle encountered in a 38-year-old male. By X-ray examination it was interpreted as benign, but endoscopy with MB scattering method revealed abnormal tiny granules of varying size on the margins of ulcer. Cancer was confirmed histologically by biopsy.

　What was common in these 2 cases is that the use of this method made it possible to effectively emphasize the fine unevenness of the gastric mucosal surface, to stain satisfactorily the area of cancer invasion and to clarify the extent of cancer infiltration. This method is confirmed as an effective method of examination in these respects. Further, not only is this procedure simple but also it has a further merit in the effectiveness of scattering dye in a very wide area of the gastric mucosa, so that this method is expected to be used widely as a highly precise routine endoscopic examination in the near future.