特殊型胃癌pT1bの臨床病理学的取扱い

Long- to-Middle-Term Prognosis after Treatment of Submucosal Invasive（T1b）Special Types of Gastric Carcinoma

要旨●特殊型胃癌の中でもリンパ球浸潤癌（GCLS），胃底腺型胃癌は比較的予後がよいことが知られている．今回筆者らは当院で内視鏡的切除を施行し，pT1bと診断されたGCLS 14例15病変と，胃底腺型胃癌13例13病変を対象とし，それらの臨床病理学的特徴と治療後の中・長期予後を検討した．経過観察は年1〜2回の上部消化管内視鏡検査と，年1回の腹部超音波検査および胸腹部CTを行った．経過観察期間はGCLSで平均4年2か月，胃底腺型胃癌で平均2年7か月であり，内視鏡的切除単独群，追加外科手術群ともに局所再発，リンパ節転移，臓器転移例は認めなかった．

　Among special types of gastric carcinoma, gastric carcinoma with lymphoid stroma and gastric adenocarcinoma of fundic gland type have a relatively good prognosis. Here, we report 15 lesions in 14 cases with gastric carcinoma with lymphoid stroma and 13 lesions in 13 cases with gastric adenocarcinoma of fundic gland type, which were diagnosed as pT1b resected through endoscopic resection at the National Cancer Center Hospital. Clinicopathologic features and medium- to long-term prognosis were examined. The average follow-up periods were 4 years and 2 months and 2 years and 7 months for gastric carcinoma with lymphoid stroma and gastric adenocarcinoma of fundic gland type, respectively. No local recurrence, lymph node metastasis, or organ metastasis was noted in the endoscopic treatment alone group or additional surgery group.