深達度smの印環細胞癌の1例

Signet-ring Cell Carcinoma with Submucosal Invasion, Report of a Case

　今日，胃癌の診断を行う場合，質的診断はもとより量的診断，すなわち浸潤範囲と深達度とを正確に診断することが当然のこととして要求されている．特に深達度は予後を左右する最も重要な因子であり，その的確な判定が求められる．

　ここに報告する症例は，一般に深達度診断の難しい未分化型癌の1つである印環細胞癌の症例で，X線および内視鏡検査における深達度診断を中心に述べる．なお，ここでは未分化型癌という言葉は未分化癌と印環細胞癌の2つを指すものとする．

　The patient, a 55-year-old woman, who had been diagnosed to have acute hepatitis and gastric cancer, was admitted to our hospital for further examination.

　Upper GI series and endoscopy showed early gastric cancer Ⅱc+Ⅲ and biopsy specimens revealed a pathological picture of signet-ring cell carcinoma.

　In this case, findings in upper GI series and endoscopy were summarized as follows:

　(1) At the tip of the folds, enlargement, disruption, gradual tapering and connection were observed, but fusion was not seen.

　(2) Rigidity of the lesion was not observed.

　(3) Plateau-like appearance of the lesion in endoscopic feature was not remarkable.

　By the combination of the above mentioned findings, the depth of cancer infiltration in this case was estimated to belong to moderately submucosal infiltrative cancer.

　But when we try to estimate the depth of cancer infiltration in the case of undifferentiated carcinoma and signet-ring cell carcinoma, we are apt to mistake. In the future, the way of estimating the depth of cancer infiltration in such cancers should be more fully discussed.