潰瘍を伴わない胃癌の発育―5症例を中心に

Development of Gastric Cancer Unaccompanied with Ulcer: centering around five illustrative cases

　病理組織学的検索により進行癌であった症例で，retrospectiveに臨床経過を追求することのできた症例，さらに早期癌でその発育過程が推定される症例を加え，主として内視鏡の立場からのべてみる．

　〔症例1〕E. S.　38歳，♂

　主　訴：自覚症状なし．

　家族歴：特記すべきことなし．

　既往歴：特記すべきことなし．

　病　歴：昭和40年某会社の胃集検を受け，胃内視鏡検査の結果，とくに異常は指摘されなかった．昭和42年にも胃集検を受けたが，同様異常は指摘されなかった．さらに昭和44年の胃集検で始めて前庭部大彎の陰影欠損を指摘され，某病院に精査のため入院した．

　A study has been made of gastric cancer cases we were able to follow up retrospectively regarding their clinical courses, together with cases of early cancer of the stomach that could possibly be anticipated of their further developmental process. All cases have been selected from those that displayed no fusion of the muscularis mucosae and the proper muscle layer. How they develop is as yet not fully ascertained, but from the clinical standpoint we assume that: Some of them may evolve from the initial change in colcr of the mucosal surface (Ⅱb-like lesion). developing into the stage of either Ⅱa-life Ⅱb or Ⅱc-like Ⅱb, finally showing a pattern of Ⅱc+Ⅱa as was illustrated in the final endoscopic of Case 5. Some of them may present findings similar to those in Case 2, while others, first showing a picture of Ⅱc+Ⅱa and on the whole looking like Ⅱa, may finally display such endoscopic pictures as were seen in Case 1.

　The presence or absence of cancer destruction, vascular invasion in the course of cancer development or some other biologic factors may be responsible for the speed of depth invasion of cancer and of its development.