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Stomach and Intestine(Tokyo) Volume 22, Issue 7 （July 1987）

胃と腸 22巻7号（1987年7月発行）

Japanese English

今月の主題腸結核と癌

主題

腸結核と大腸癌 Intestinal Tuberculosis and Cancer of the Colon 八尾恒良 ¹ , 岩下明徳 ² , 飯田三雄 ³ , 坂本清人 ⁴ , 田中啓二 ⁵ Tsuneyoshi Yao ¹ ¹福岡大学筑紫病院内科 ²松山赤十字病院検査部 ³九州大学医学部第2内科 ⁴九州中央病院内科 ⁵福岡市医師会病院 ¹Department of Gastroenterology, Chikushi Hospital, Fukuoka University pp.765-780

発行日 1987年7月25日 Published Date 1987/7/25

DOI https://doi.org/10.11477/mf.1403112932

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要旨　自験6例の同部位腸結核合併大腸癌を呈示し，本邦文献を渉猟して，同部位腸結核合併大腸癌39例と他部位腸結核合併大腸癌7例を蒐集した．同部位腸結核合併大腸癌を分析して以下の結果を得た．①一般の大腸癌に比べ有意に女性が多い．②病変部位は有意に盲腸～上行結腸が多く，S状結腸，直腸が有意に少ない．③5型の肉眼型が有意に多く，2型が有意に少ない．④活動性肺結核合併は1例(4.2％)にすぎず，他は陳旧性腸結核合併例か，胸写上異常のないものであった．⑤記載された29例中，9例(31.0％)が，診断される8～59年以前に腸結核に感染または，感染する機会を有していた．3年以内に感染または感染の機会があった症例はなかった．⑥癌のほかにいわゆるdysplasiaを有した症例が少なくとも3例に認められた．以上の成績に考察を加え，同部位腸結核合併大腸癌では，腸結核の大腸粘膜を発生母地とする大腸癌の存在を否定できないと考えた．

　We have presented six cases with colonic cancer complicated with intestinal tuberculosis at the same site. In addition, on a survey of Japanese literature, we have collected 39 cases wlth colonic cancer complicated with intestinal tuberculosis at the same site, and seven cases with that at different sites. Cases with colonic cancer complicated with intestinal tuberculosis at the same site were analyzed and the results as follows have been obtained.

　1) Sex preponderance in female was seen as compared to colonic cancer uncomplicated with intestinal tuberculosis.

　2) The most frequent site of involvement was the cecum and ascending colon, and the lesions in the sigmoid colon and rectum were significantly infrequent.

　3) Macroscopically, there were significantly a large number of cancer of type 5, and the lesions of type 2 were significantly infrequent.

　4) There were only one case (4.2%) who concomitantly had active pulmonary tuberculosis. The others had either old pulmonary tuberculous lesions or no abnormality on chest x-ray films.

　5) Among 29 cases with pertinent descriptions, nine cases (31.0%) either had been infected, or had met with a chance of infection with intestinal tuberculosis eight to fifty-nine years prior to the diagnosis. There were no case who had been infected with intestinal tuberculosis within three years before diagnosis.

　6) There were at least three cases who had so called dysplasia in addition to cancer.

　It was assessed, taking those results into consideration, that a possibility of colonic cancer generating on the mucosa affected with tuberculosis may not be negated.