Ⅱc（Ul－）からBorrmann 2型胃癌への発育が4年8か月にわたり逆追跡された1例

Retrospectively Observed Gastric Cancer Developed from Ⅱc (UI-) to Borrmann Type 2 during 4 Years and 8 Months, Report of a Case

要旨　胃角部のⅡc（Ul－)（生検組織の見直しで癌陽性)から肝転移を有するBorrmann2型胃癌への発育が，4年8か月にわたり内視鏡およびX線検査で経過観察された症例を報告した．本症例は粘膜内にとどまるⅡcの段階ではほとんど形態変化を認めず，急速に形態の変化を示して進行癌に発育した．胃癌はある時点を過ぎると急速に進展すると考えられ，なかでも潰瘍を伴わない限局型胃癌は急速な発育を示すことが多い．本例は，胃癌が早期癌として肉眼的に認識されるようになってから潰瘍合併所見を認めないまま肝転移を伴った進行胃癌へ発育するまでのほぼ全過程が捉えられたまれな症例と考えられる．

　A retrospectively observed gastric cancer Borrmann type 2 with liver metastasis was reported. Gastrofiberscopy was performed four times and x-ray examination was performed three times in the course of four years and eight months, during which time the cancer developed from Ⅱc without ulceration to Borrmann type 2. In the first period of about four years, the lesion was regarded as remaining as an early cancer, and little morphological change was observed. In the latter period of about one and half years, the lesion developed very rapidly into an advanced cancer Borrmann type 2. Many clinical studies have gradually made it clear, that the growth of a gastric cancer is slow when it is in the stage of early cancer, and that the fibrosis due to peptic ulcer is one of the factors inhibitory to the growth of the cancer.

　This case proved that the cancer does not develop at a uniform rate, and an early gastric cancer without ulceration develops into an advanced cancer rapidly.