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要旨●A型胃炎を背景に発生する胃NETは,I型胃NETに分類され,腫瘍径は小さく多発性であり,病理組織学的にも低悪性度で,予後がよいのが特徴とされる.本邦をはじめとしたこれまでの報告は,そのような特徴に沿うものが多かった.しかし,最近になり,リンパ節転移や肝転移を来すI型胃NET症例が,低頻度ながら存在することが明らかになり,その臨床的特徴として,①腫瘍径10mm以上,②Ki-67 index高値,③固有筋層以深の深部浸潤,などの危険因子が挙げられている.現在,本邦のI型胃NETの研究において,200例の登録が終了し,データの解析に入っており,その結果が注目される.
Gastric NETs complicated with type A gastritis are classified as type I gastric NETs. Type I gastric NETs are small in size, many in number, and histologically well-differentiated ; therefore, they have a good prognosis. Many past reports, including those from Japan, have reported these characteristics. However, it has recently been reported that type I gastric NETs complicated with lymph node and liver metastasis exist with a low incidence. The clinical features of such type I gastric NETs are as follows:1)tumor diameter ≧10mm, 2)high Ki-67 index, and 3)invasion beyond submucosa. Currently, a total of 200 cases have been registered and analyzed for studying type I gastric NET in Japan.
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