胃癌の診断にX線検査は不要か―外科的治療の立場からみた考察

The Significance of X-ray Examination in the Diagnosis of Gastric Cancer: Analysis from the Surgical Standpoint of View

要旨　胃癌診断におけるX線検査の意義を内視鏡検査と対照しつつ検討して以下の結果を得た．①早期癌の深達度および浸潤範囲診断の正診率では内視鏡検査がX線検査に勝っていた．②進行癌浸潤範囲の検討ではt₃，t₄症例においてはX線検査が内視鏡検査に比べて勝っていた．③X線検査は早期癌では大・小彎に主座を持つ病変の深達度診断，胃小区所見の読影による深達度・浸潤範囲診断などに有用であった．また進行癌では浸潤型癌の全体像把握と大・小彎に主座を持つ病変の深達度判定などに有用であった．④胃癌の診断においてX線検査は固有の役割を持っており，その意義は検査・診断技術の向上により更に深くなるものと思われた．

　We evaluated the significance of x-ray examination in the diagnosis of gastric cancer compared with endoscopic examination, and got the following results. 1) X-ray examination was inferior to endoscopic examination in accuracy of the depth and extent of invasion for early cases. 2) X-ray examination was superior to endoscopic examination in the diagnosis of the extent of invasion in t₃ or t₄ cases of advanced cancer. 3) X-ray examination was useful in the diagnosis of the extent of invasion for early cases which are located in the greater or lesser curvature. Findings of gastric area were also useful in the diagnosis of the depth and extent of invasion for early cases. 4) X-ray examination was useful for getting the total figure and diagnosis of the depth of invasion for such advanced cancer as type 3 or type 4. We concluded that the significance of x-ray examination was not small, and its utility will be growing if technical advances have been made in its use.