m3・sm1食道癌のX線診断

Radiological Study of Differential Diagnosis in m3 and sm1 Early Esophageal Carcinomas: Comparison with Postoperative Radiogram

要旨　外科切除されたm₃の6例とsm₁の2例について，精密X線像，術後像，そして，組織学的所見を対比しX線学的深達度診断を検討した．切除標本の検討から，①粘膜面の凹凸や厚みがみられその部で浸潤している例と，②病変のごく一部で粘膜面の凹凸や厚みを伴わずにpin pointに浸潤した例があり，各々4例ずつあった．1群4例のX線診断をみると，正診2例，m₃をm₂と診断したのが1例，sm₁をsm₃と診断したのが1例あった．これらの例では粘膜面の凹凸や厚みが主として辺縁像の不整として描出されたので，浸潤している部位は同定できたが，その判断に問題があった．一方，2群4例のX線診断をみると，その浸潤部位が同定できず全例浅く診断していた．以上から，この領域のX線学的深達度診断を確立するためには，今後とも詳細な組織像とX線像を対比した症例の蓄積が必要である．

　In the last four years, six cases of m₃ carcinoma and two cases of sm₁ carcinoma were detected in our center and treated by radical esophagectomy. By morphological study, eight cases were divided into two groups. 1) In four cases which had thickness or irregularity of esophageal mucosa we could diagnose the depth of invasion in m₃ or sm₁ by radiological study. 2) In the other four cases little which had thickness or irregularity of esophageal mucosa we misdiagnosed the carcinoma as shallow invasion. Briefly, the differential diagnosis in m₃ and sm₁ is difficult due to the small number of cases treated radiologically. We must accumulate data from cases in which we can compare the radiogram to the resected specimen with scientific exactitude.