胃潰瘍の背景としての胃粘膜―内視鏡的立場より

Gastroscopic Studies of the Mucosa in Gastric Ulcers

　胃粘膜変化としての慢性胃炎と病変に共存した粘膜変化については，今までに数多くの内視鏡による報告がある．今回，われわれは胃潰瘍を中心に，その背景にみられた病変について内視鏡的立場から述べる．

　当教室における1960年10月から1973年8月までの約13年間の胃内視鏡検査総例数12,886症例中，潰瘍は3,554症例（約27％）である．このうち，1年以上経過観察をした症例は481例である．これらの胃潰瘍をもとに，その背景としての胃粘膜所見を，①胃潰瘍と併存した胃病変，②胃潰瘍経過観察時の粘膜所見，について検討する．

　Of 12,886 patients examined by gastric endoscopy, ulcer was seen in 3,554 (27 per cent). Of these ulcer cases, 481 were follow up from over one year to twelve years.

　1. Lesions associated with gastric ulcer were mostly cancer or polyp, followed far less frequently by submucosal tumors and varices.

　2. Gastric cancers found in the course of ulcer follow-up were mostly located at some distance from ulcer, and the bulk of them belonged to early cancer.

　3. Advanced carcinoma was often seen away from ulcer in those cases that were not followed up periodically.

　4. Mucosal changes were mostly seen in the vicinity of ulcer in cases followed up less than five years long, while they were very often observed in regions way off ulcer in those followed up for more than five years.

　Some comments have also been made on concomitant lesions of gastric ulcer reported in the literature.