X線診断における陥凹型胃癌の深達度推定

The Presumable Depth of Invasion in Gastric Cancer of the Depressed Type in Radiological Diagnosis

　早期胃癌の診断は，もはや日常的なルチーン・ワークとなっており，また，胃癌深達度推定についての試みがなされてから十余年を経た今日では，ある程度の深達度診断もごく普通に行なわれている現状である．

　陥凹型胃癌の深達度診断の指標としては，多くの研究^1)～10)により癌病巣の大きさ，境界鮮明度，陥凹の深さ，陥凹の輪郭の形，陥凹の内部および周辺の隆起，び漫性膨隆，集中・中断する粘膜ひだの蚕喰，腫大，融合などが挙げられており，それぞれその規模の大なるほど，また不整なものほど深達度は深いとされている．X線診断においても，これらの従来の所見を正面像および側面像として捕えることによって活用されている．

　We have attempted to find, if any, possible characteristics contributing to the radiological estimation of the depth of invasion in gastric cancer of the depressed type. The results are summarized as follows:

　1) In the radiological diagnosis with an application of “the former diagnostic criteria for cancer with submucosal invasion (sm cancer)”, the estimation in the depth of invasion in sm cancer was correct in 40.6 per cent.

　2) In the review of our classification into irregularity (＋) and irregularity (±) in the grade of an irregularity of finely granular appearances within type IIc lesion, irregularity (＋) was frequent in sm cance and infrequent in cancer involving only the mucosa (m cancer).

　On the contrary, irregularity (±) tended to be frequent in m cancer and infrequent in sm cancer. On the other hand, irregularity (±) was uncommon in gastric cancer with intramuscular invasion (pm cancer).

　3) By the combination of the above mentioned r“irregularity” findings and the “the former diagnostic criteria for sm cancer”, we were able to obtain correct estimation of the depth of invasion in sm cancer in 82.8 per cent.