“いわゆる早期胃癌類似進行癌”症例とその問題点

Cases of So-called “Advanced Carcinoma Simulating Early Cancer” and Issues on the Macroscopic Classification of Gastric Cancer

要旨　早期癌病型に類似した病巣を持った進行胃癌（“類進”）には，肉眼的に早期癌と診断したが，組織学的検索により癌がわずかに深達していた“早期癌類似の深達癌”（“類早”）と，肉眼的に既に進行癌と診断できるが，肉眼病型が早期癌病型に類似している“早期癌病型の進行癌”（“早型進”）の2種類があることを述べ，その代表的な4症例を示した．次いで，これら肉眼病型分類の問題点を挙げ，その対策についても触れた．

　Advanced carcinoma of the stomach macroscopically resembles early carcinoma in two ways. One occasion is that although carcinoma was initially diagnosed as in the early stage histological examination shows cancer cells in deeper layer than expected. The other is that although carcinoma was already recognized as having deeply penetrated it nevertheless looks more early-type than Borrmann-type. The former was called as “advanced carcinoma simulating early carcinoma” and the latter “advanced carcinoma resembling macroscopic early-type”. Four cases of these carcinomas were shown in Figs. 1-7.

　We discussed controversial issues regarding macroscopic classification of gastric carcinoma while taking into consideration the accuracy of macroscopically classified carcinoma in diagnosis (Table 1). Some measures to solve these issues were also advanced.