陥凹性早期胃癌のX線所見と病理組織所見の比較

A Comparative Study between Histopathological and Radiological Findings of Depressed Early Carcinoma of the Stomach

　陥凹性早期胃癌のX線所見には，当然のことながら，典型例および非典型例が存在する．このことは，X線撮影の技術的なこと以外にⅡcの肉眼所見ならびに組織学的所見の差に影響されていることが考えられる．すなわち，文献的に典型的Ⅱcと見なされるX線所見の肉眼所見ならびに組織学的所見をみると，それらの多くが未分化型癌であって分化型癌は少ない．また，経験的にもX線所見上で典型的Ⅱcとされたものの多くは組織学的に未分化型癌で，非典型的Ⅱcとされたものには分化型癌が多い傾向がみられている．これらのことから，陥凹性早期胃癌のX線上の所見は，癌の組織型によって異なるとの見方ができる．

　本研究は，この問題を解明するために，陥凹性早期胃癌のX線所見と病理組織学的所見との関係について検討を行なったものである．

　A comparative study was made on the characteristics between histological type, and macroscopical and radiological finding of 220 cases of depressed early carcinoma which had been experienced in the period of 8 years from 1965 to 1972 at the Cancer Institute Hospital, Tokyo. The following result was obtained: (1) In the most cases of depressed early carninoma, the histological type is related closely to the characteristic macroscopical finding and the double contrast image of them. Generally most undifferentiated carcinomas show typical macroscopical and radiological sign of Ⅱc-lesion that is recognizable easily. On the other hand, in most cases of differentiated carcinema their macroscopical and radiological sign a is not typical of Ⅱc-lesion but simulating Ⅱ b-like lesion without distinct outline, unless they have raised margin. (2) It may depend on the mode of growth and development as well as the histological type of carcinoma whether surface of a Ⅱc-lesion or its outline is recognized easily or not. An outline of a Ⅱc-lesion can not be traced, especially when there is histological and macroscopical similarity between cancerous lesion and adjacent noncancerous mucosa. Histologically, there also exists some morphologica similarity between the differentiated carcinoma and the normal gastric mucosa.

　Thus, macroscopical and histological characteristics should be taken into consideration for the radiological diagnosis of depressed early carcinoma of the stomach.