潰瘍性大腸炎に合併した大腸癌2例の臨床・病理学的検討

Ulcerative Colitis Complicated Carcinoma of the Large Intestine, Report of Two Cases

要旨　潰瘍性大腸炎に合併した大腸癌2症例を経験した．2例とも再燃，緩解を繰り返す全大腸炎症例で，癌が発見されるまでの病悩期間は18年，9年であった．摘出標本の病理組織学的検索では1例は多発癌で，緩解期の潰瘍性大腸炎に高分化腺癌と粘液癌があり，癌より離れた部位にdysplasiaがあった．また，他の1例は単発癌で，陰窩膿瘍を伴う活動期の潰瘍性大腸炎に高分化腺癌を認めたが，検索した範囲にdysplasiaはなかった．手術後8か月と2年3か月を経過した現在，両者ともに健在である．2例とも進行癌で発見されており，早期発見のためにcolonoscopyによる生検でdysplasiaを検索することが重要と考えられた．

　Two cases of ulcerative colitis complicated carcinoma of the large intestine were represented. Both involved the whole colon and were remitting and relapsing types. The periods from the onset of colitis to the clinical signs of the carcinomas were 9 years and 18 years respectively. Pathologically, one case involved complicated multiple carcinomas (well differentiated and mucinous carcinoma) and dysplasia was found apart from the carcinomatous foci. The other case involved a complicated single well differentiated carcinoma and dysplasia was not associated with it. At present, both cases show no clinical signs of recurrence of the carcinoma. One case was operated on eight month ago, the other case was operated on two years and three month ago. Colonoscopic cancer surveillance to investigate dysplasia should be done at regular intervals to discover any development of carcinomas at a relatively early stage.