H. pylori未感染胃上皮性腫瘍を意識したX線読影上の注意点

Points to Note for X-ray Interpretation in Consideration of Gastric Carcinoma/Adenoma without Helicobacter Pylori Infection

要旨●H. pylori（Helicobacter pylori）未感染胃に発生した胃癌9例を用いてX線読影上の注意点を検討した．H. pylori未感染胃における上皮性腫瘍の発生部位と組織型には関連があり，少なくとも①胃噴門部癌・食道胃接合部腺癌，②胃底腺領域における胃型形質の（低異型度）分化型腺癌，③胃底腺と幽門腺境界領域の印環細胞癌・低分化腺癌，④前庭部のびらん類似型の高分化型腺癌，の4つのtypeが挙げられる．X線によるスクリーニング検査における読影では，H. pylori未感染胃と診断した場合には上記を念頭に置きながら読影することが重要である．

　The X-ray images of nine gastric carcinoma patients who developed the disease without a H. pylori（Helicobacter pylori）infection were used to evaluate points to which attention should be paid while interpreting X-ray images. The following four types of associations were reported between the site of onset and the histological type of epithelial neoplasia in the stomachs of such patients：（1）carcinoma of the gastric cardia or adenocarcinoma of the esophagogastric junction ; （2）differentiated adenocarcinoma with a gastric phenotype（low atypical grade）in the mucosa of the fundic gland region ; （3）signet ring cell carcinoma or poorly differentiated adenocarcinoma in the gastric fundic gland and pyloric gland border region ; and（4）well-differentiated adenocarcinoma of erosion-like phenotype in the gastric antrum. Therefore, while interpreting X-rays of patients without an H. pylori infection, it is pertinent to consider the aforementioned conditions.