Ⅰ型早期胃低分化腺癌の臨床病理学的観察

Type Ⅰ Early Gastric Carcinoma Consisting of Poorly Differentiated Adenocarcinoma: A Clinicopathologic Study

要旨　低分化腺癌から成るⅠ型早期胃癌7例の臨床病理学的特徴を探求するために，高分化管状腺癌から成るⅠ型早期胃癌21例と比較観察した．前者では後者に比し，患者の平均年齢が低く，女性の割合が多く胃の高位に存在することが多かった．低分化腺癌では全例が粘膜下層まで浸潤を来しており，組織学的には髄様型癌で，腫瘍細胞は充実胞巣状に増殖していた．また，間質には血管が豊富で，滲出性間質反応が高度であった．リンパ節転移や肝転移のみられた例はなく，癌以外の原因で死亡した2例を除く全例が健在である．なお，これらの中には高度の貧血および低蛋白血症を示す例が1例，神経内分泌顆粒陽性細胞が多数みられる例が1例あった．

　We studied a total of seven cases of type Ⅰ early gastric carcinoma consisting of poorly differentiated adenocarcinoma, comparing them with 21 cases of well differentiated tubular adenocarcinoma of the same gross type. In the former, the patients were younger than in the latter, there was a female preponderance, and the tumors were located in the upper portion of the stomach. Not only the mucosa but the submucosa was involved by the malignant tissue in all seven cases. Tumor cells showing solid nests or cords proliferated in a medullary fashion with the narrow stroma containing a marked lymphoid infiltrate and richly vascular spaces. No case had metastases to lymph nodes, liver or other sites and all patients were free of disease for one month to five years after surgery. Interestingly, one of the cases had severe anemia and hypoproteinemia that improved after removal of the stomach. Another particular one had numerous tumor cells with argentaffine granules.