胃癌における石灰沈着について

ON CALCIUM DEPOSIT IN GASTRIC CANCER

胃癌における石灰沈着

Ⅰ．はじめに

　胃癌組織中に石灰沈着がみられるという最初の記載は，1931年のImbertによるものであって，以来諸外国では25例が，本邦では3例の報告がみられるにすぎない．

　石灰沈着現象自体はいかなる臓器にも起こり得る．しかしながら，悪性腫瘍組織中に石灰沈着の生ずることは比較的少なく，ことに胃癌ではまれとされてきた．最近は腫瘍組織の詳細な検討によって，乳癌などではかなりの頻度に石灰沈着を伴っていることが知られている．

　胃癌における石灰沈着の報告は少なく，自験例を除けば外国で25例，本邦で3例の文献的記載がみられ，いずれも極めてまれなものとして扱われてきた．

　筆者は本学病理教室における過去3年間の外来手術胃標本（癌）約200例のうちで1例，剖検例90のうち4例に腫瘍組織中に石灰沈着がみられたので，従来いわれるほど胃癌における石灰沈着がまれではないことを指摘し，併せて若干の考察を加えたい．

　Calcium deposit associated with cancer of the stomach, considered as of rare occurrence hitherto, has been experienced in five cases of colloidal cancer of the stomach, four among 90 autopsies and 1 in 200 gastric cancer operation. All cases of calcification in gastric cancer were found only in mucinous cell carcinoma, or Gallertkrebs, and for its causes following points must be taken into account.

　(1) Even in case of intermixed varieties of histological pictures, calcium deposit is always observed only in the site of colloidal cancer or mucinous cell carcinoma. (2) Secretion from this deposit is what is called mucopolysaccharide. (3) Such factors as alkalinity and high output of alkaliphosphatase caused by tissue degeneration within a bottled-up environment that a tumor is, play a great role in facilitating the formation of calcium salts along with changes in the mucous element. In the past, 25 cases in foreign countries and 3 in Japan have been reported so far, but if clinical and histological investigations are done more minutely, calcium deposit in gastric cancer shall possibly be observed in an increasing number.