胃X線所見と切除標本所見との対比―方法と問題点

Comparisons between Radiographic Findings and Gross and Histological Findings of the Resected Specimen: Methods and Problems

要旨　5例の胃癌例（早期胃癌4例，進行癌1例）を対象として，X線写真と切除標本ならびに組織所見との対比の方法と実際を呈示し，問題点について述べた．病変によっては術前のX線像，切除胃標本のX線像，切除胃標本の肉眼像の現れ方が異なることがわかった．正確な術前のX線診断を行うためには，画像の質と情報量の多い写真を撮影することがまず大切である．そして，現れた像を注意深く観察し読み取り，それらを切除標本の肉眼所見と詳細な組織検索の所見と対比することによって，初めて正確なX線診断が可能になる．また，通常の検査で発見が困難な病変に対しては，術後の新鮮標本（未切開）あるいは固定標本のX線写真を撮影しておくことが，発見の手掛かりを得る方法として重要である．これらを遂行するためには，外科と病理の理解と協力が必要である．

　Methods of comparing radiography, gross findings of resected specimen and histology were shown with respect to 5 cases of gastric cancer (early cancer 4 cases, advanced cancer 1 case).

　It became clear that there were some lesions in which preoperative radiography, radiography of the resected specimen and gross findings all appeared quite differently. In order to make precise preoperative radiographic diagnoses it is most important to take high quality pictures rich in information.

　These pictures then should be cautiously interpreted comparing with both gross and histological findings of the resected specimen. In cases with the lesion difficult to detect by conventional methods radiograms of postoperative fresh specimen (before cutting) or fixed specimen are useful in getting clues to the detection. It goes without saying that cooperation with surgeons and pathologists are mandatory to carry out these tasks.