石灰化を伴う胃癌の病理組織学的検討

Histopathological Studies on Gastric Carcinomas with Calcification

要旨　胃癌切除例107例を検討した結果，9例（8.4％）10病巣の胃癌組織中に石灰化を認めた．いずれも進行癌で，大部分はstageⅣ（胃癌取扱い規約）であったが，臨床的に電解質の異常などはみられなかった．石灰化の型を今井の分類に従って分けると，mucin Pool calcification 6病巣，psarnmomatous calcification 4病巣で，前者は比較的分化度の高い腫瘍組織中に，後者は分化度のより低い腫瘍組織中に出現する傾向がみられた．また9例中2例では転移巣にも石灰化がみられ，原発巣における前記傾向と同様，転移巣の腫瘍像の変化と共に石灰化の型も変わった．以上の所見から，石灰化の型には周辺の腫瘍組織の分化度が深く関与している可能性が老えられた．石灰化を伴う胃癌10病巣中2病巣で，腫瘍細胞の胞体がcalcitonin陽性を示すという興味深い所見を得た．

　Histopathological studies on gastric carcinoma associated with calcification were done.

　Calcifications were found in 9 cases (8.4%) or 10 lesions out of 107 cases of gastric carcinoma studied. Staging of all cases with calcification were advanced cancer, and most of cases were determined as stage Ⅳ by the general rule adapted by the Japanese Society for Gastric Cancer. Few abnormalities of serum electrolites in these cases were found.

　As far as the types of calcification were concerned, mucin pool calcification of six and psammomatous calcification of four lesions were determined according to the Imai's classification. The former calcifications existed in more differentiated tumor tissue and the latter in less differentiated lesions. In addition, calcifications were also found in metastatic foci in two of them, and changes of types of calcifications were associated with these of histological feature of tumor tissues. From these findings, it is suggested that the type of calcification may depend upon the histological differentiation of the tumor.

　It is of interest that calcitonin was stained in two of these lesions ; further observations of calcitonin staining are now in progress.