Linitis plastica型胃癌の原発巣と経時的変化

The Primary Foci of Linitis Plastics Type of Gastric Cancer and Their Chronological Changes

　Linitis plastica型胃癌は，急激な進展を来しleather bottle様の外観を呈する最も予後の悪い肉眼型の胃癌である．近年，その原発巣に関する主として病理組織学的研究^1)～7)が散見されるが，臨床資料による原発巣ならびに経時的変化についてのまとまった研究はいまだ数少ない．われわれは，比較的病巣が小さい時期に発見されたが種々の理由で経過観察がなされ，手術あるいは剖検で病理組織学的検索が可能であったlinitis plastica型癌を7例経験した．本稿では，これら7例の初回検査時のX線，内視鏡的特徴と病巣内潰瘍の変化について検討を加え，代表的症例を呈示する．

　A study has been made of seven cases of linitis plastics type of gastric cancer. All the lesions were small when they were detected, but for various reasons we were compelled to follow them up for more than eight months until finally we were able to study them histologically. The lesions found at the initial examination were mostly Ⅱc type depressed ones, located either in the area of the fundic gland or in the transitional zone. Their morphological features consisted of marginal rigidity, plateau-like elevations and elevated areas surrounding the lesions. These findings led us to assume that cancer taking the shape of linitis plastica type must have a tendency to infiltrate within the mucosa in an early stage of cancer development. In the course of follow-up deep ulcers arose in three cases. They were either reduced in size, scarred or showed recrudescence. However, ulcers did not arrest the growth of cancer itself, probably because advanced cancer development already present in the submucosa was not influenced by ulcers.