Helicobacter pylori除菌後10年以上を経過後発生した胃癌症例

Gastric Cancer which was Diagnosed 10 Year or Later after Eradication of Helicobacter pylori

要旨　〔症例1〕78歳，男性（除菌時：除菌から癌診断＝67歳：10年10か月）．十二指腸潰瘍で除菌．胃体下部小彎前壁の0-IIc（por2）．萎縮はC-3．幽門側胃切除術施行．20×17mm，深達度M．〔症例2〕66歳，男性（55歳：11年4か月）．胃潰瘍で除菌．前庭部大彎の0-IIc（tub1）．萎縮はO-3．ESD施行．4×4mm，深達度M．〔症例3〕72歳，男性（57歳：14年2か月）．胃潰瘍瘢痕で除菌．前庭部後壁の0-IIc（tub1）．萎縮はC-3．ESD施行．12×10mm，深達度M．〔症例4〕81歳，男性（70歳：10年6か月）．胃潰瘍で除菌．胃体上部後壁に0-IIc（tub1）．萎縮はO-1．ESD施行．18×15mm，深達度M．〔症例5〕82歳，男性（71歳：11年11か月）．慢性胃炎で除菌．胃体上部後壁に8mm大の0-IIa＋IIc（tub2）病変を認めた．萎縮はO-1．除菌後10年以上の経過で診断された癌は，胃粘膜萎縮の程度にかかわらず発生し，高分化型，低分化型の両者がみられた．

　〔Case 1〕 a 78y.o. male（Interval between eradication and cancer diagnosis ; 10years 10months）was diagnosed with type 0-IIc（poorly differentiated adenocarcinoma : por2）at the lesser curvature of gastric body and underwent surgery. Tumor size was 20×17mm with mucosal layer invasion. Degree of atrophy was C-3 type according to Kimura-Takemoto classification.〔Case 2〕 a 66y.o. male（11years 4months）was diagnosed with type 0-IIc（well differentiated adenocarcinoma : tub1）at the greater curvature of the antrum and underwent ESD. Tumor size was 4×4mm with mucosal layer invasion. Degree of atrophy was O-3.〔Case 3〕 a 72y.o. male（14years 2months）was diagnosed with type 0-IIc（tub1）at the posterior wall of the antrum and underwent ESD. Tumor size was 12×10mm with mucosal layer invasion. Degree of atrophy was C-3.〔Case 4〕 an 81y.o. male（10years 6months）was diagnosed with type 0-IIc（tub1）at the posterior wall of gastric body and underwent ESD. Tumor size was 18×15mm with mucosal layer invasion. Degree of atrophy was O-1.〔Case 5〕 an 82y.o. male（11years 11months）was diagnosed with type 0-IIa＋IIc（tub2）at the posterior wall of gastric body. Degree of atrophy was O-1. Gastric cancer which was diagnosed 10 year or later after eradication was characterized by the fact that gastric cancer occurred regardless of the degree of atrophy and its histological type involved well to poorly-differentiated types.