早期胃癌の病理学的な時代的変遷

Changing Trends of Pathological Findings in Early Gastric Cancer

要旨●当施設における1977〜2021年（45年間）の早期胃癌症例の時代的変遷を検討した．その結果，患者の平均年齢の高齢化，比較的小さな粘膜内癌の増加，肉眼的には隆起型，特に0-IIa型病変の増加と癌巣内潰瘍を合併する病変の減少，組織学的には低異型度の分化型癌の増加と未分化型癌の減少が明らかとなった．これらの変化は診断能力の向上，人口の高齢化とHelicobacter pylori感染率・除菌率の変化が影響していると考えられた．今後は早期胃癌数の減少，症例のさらなる高齢化，小さな低異型度の分化型癌の増加が予想される．

　We investigated the changing trends in cases of early gastric cancer from 1977 to 2021 at our institution. The findings revealed patients' aging with an increase in relatively small intramucosal cancer, increase in macroscopically elevated lesions, especially 0 and IIa lesions, decrease in lesions with an intratumoral ulcer, increase in histologically low-grade differentiated carcinomas, and decrease in undifferentiated carcinomas. These changes are influenced by population aging as well as changes in the Helicobacter pylori infection and eradication rates. In the future, the number of cases with early gastric cancer is predicted to decline, and the cases are further aging and small, low-grade differentiated carcinomas increase.