胃のいわゆる隆起性異型上皮の臨床細胞学的検討

Cytological Studies on So-called Atypical Epithelium of the Protuberant Lesion in the Stomach

　1960年代半ば以降，胃の隆起性病変に関する病理組織学的検索が進むにつれて，良性悪性の境界領域病変と考えられるいわゆる異型上皮という概念が登場し^1)～8)，臨床的にも種々の検討が行なわれるようになった．臨床細胞診の分野でも1970年頃から異型上皮の細胞像についての研究成果が盛んに発表されるようになり^9)～18)，異型上皮の組織診と細胞診が高い合致率を示したという報告もみられるようになった¹⁶⁾¹⁸⁾．

　胃隆起性異型上皮由来の細胞パターンに関する諸家の報告をみると，核は長楕円形で細長く，大型核はみられない，核クロマチンは微細均等分布を示す，細胞は重積性著明で，散在傾向に乏しい等の点でほぼ一致している．

　Since the middle of 1960's histopathological studies on the protuberant lesions of the stomach have been developed and so-called atypical epithelium considered as a border-line lesion between benign and malignant changes has come to be acknowledged as an independent disease. We studied morphological characteristics of it in thirty-one cases with thirty-two lesions of the stomach and came to the following conclusion.

　1) As a rule, the nuclei are oblong and most of them are 14～17 μ in major axis and 6～8 μ in minor.

　2) The nuclear chromatin is distributed finely, equally and densely, The nucleolus is not conspicuous.

　3) The nuclei are packed remarkably in groups and piled upon one another. Larger group of cells is often subdivided into some smaller groups. The polarity of the nuclear arrangement in the subdivision is relatively kept in regularity, The surrounding cells are often arranged radially to the group,As a rule, the groups of cells are closely bound, In cases of atypical epithelium with high grade atypia, however, the cells are apt to lie scattered partially in their arrangement.