組織混在型早期胃癌の内視鏡的特徴―通常内視鏡

Endoscopic Findings of Early Gastric Cancers of Mixed Differentiated Type: Conventional Endoscopy

要旨　当センターの組織混在型早期胃癌と純粋型の分化型・未分化型早期胃癌の通常内視鏡像を比較し，組織混在型早期胃癌の通常内視鏡観察における特徴を検討した．872症例，1,047病変を検討した結果，純粋分化型と比較し，混在型は“M領域に位置する”，“萎縮境界もしくは非萎縮領域に位置する”，“0-IIc型である”，“20mm以上である”，“潰瘍瘢痕を伴う”，“SMに浸潤している”傾向を示した．また，純粋未分化型と比較して，混在型は，“萎縮領域に位置する”，“発赤調である”，“SMに浸潤している”傾向にあった．術前に分化型癌と診断しても，萎縮境界付近に位置する褪色調の陥凹性病変で，20mmを超える病変や，潰瘍瘢痕を有する病変は，未分化型成分が混在している組織混在型早期胃癌の可能性があり，SM浸潤の可能性も含め十分な注意が必要である．

　We evaluated endoscopic findings of mixed differentiated early gastric cancers using conventional endoscopy.

　We checked and reviewed endoscopic figures and pathological results of 1047 lesions. The early gastric cancers of mixed differentiated type tended to be located at the middle of the stomach, located in the margin of atrophic area or unatrophic area, 0-IIc type, more than 20mm in size, or which have ulceration findings comparable with differentiated early gastric cancers, and which are located in the atrophic area or are reddish colored compared with undifferentiated early gastric cancer.

　Even if biopsy specimens revealed differentiated adenocarcinoma, we should observe them carefully when we see discolored depressive lesions with ulcerative findings those were located near the margin of atrophic area or more than 20mm in size, because there might be some parts of undifferentiated component in those lesions