喉頭癌の早期診断，早期治療を妨げる要因について

FACTORS CAUSING DELAY IN THE DIAGNOSIS OF LARYNGEAL CANCER

　呼吸困難のため気管切開術を行なつた75例の喉頭癌，下咽頭癌症例を臨床病理学的に検討を行ない，早期診断，早期治療を妨げた諸要因の解析を行なつた。患者側の責になる要因，さらに医師側の責に帰せられるべぎ要因について検討を行なつた。後者の責任となるべき諸要因については反省と改善の可能性はあるが，前者の場合には困難なことが多く，社会啓蒙的なcampaignを正しく行なう必要を痛感した。

　気管切開群の5年粗生存率は50％前後となり，特に下咽頭癌の気管切開群では治癒の期待を持てないことを示した。

　喉頭癌診断は視診が根底であり，この見えるということは強力な診断法ではあるが，逆にその判定が誤まつた場合には決定的な失敗につながるので注意すべきである。

　During the ten years from 1958 to 1967 at the Osaka University Medical School, there were 61 cases that required tracheotomy for relief of breathing difficulty from among 468 patients who were previously operated for laryngeal cancer and 14 similar cases from the 106 operated previously for hypopharyngeal cancer. The five-year life sustainance among those that required tracheotomy in the treatment of laryngeal cancer was 57%; whereas, similar rate for those operated for laryngeal cancer alone was 72%. The prognosis for hypopharyngeal cancers appeared to be poor.

　Generally speaking, an early diagnosis in laryngeal cancer is the rule because the lesion is readily visible.

　However, the diagnosis may be delayed with the responsibility resting on the two parties concerned, namely the patient and the doctor. The possible faults of both parties are well described.