Linitis plastica早期発見のためのretrospective study

Retrospective Study of Linitis Plastica

　早期胃癌診断は大きさ，高低，あるいは形状などの諸問題を次々に解決し，その奥義を極めるところまで達しているといっても過言ではない．しかし，目を転じて現実の臨床の場に立ってみると，まだまだ進行癌が優勢であり，早期胃癌の診断学が十分に活用されているとはいい難い．その1つに，短期間に急激な形態的変化を示すlinitis plastica型胃癌があり，しかもこのtypeの癌は比較的若年者に多く，予後も極めて不良であるので，その早期診断が切望されている．

　本稿では，経過観察できたlinitis plastica型癌症例において，その早期発見を目的としてretrospectiveに初期像，進展形式，原発巣，および検査法を中心に検討する．

　A study was made on 7 cases of linitis plastica which were followed up from the period of 3 weeks to that of 3 years and 3 months. The following results were obtained.

　1) In all cases, the primary lesions existed in the corpus, and could be picked up retrospectively even in the first x-ray examinations.

　2) Early cancer of Ⅱc+Ⅲ may be one of the primary lesions of linitis plastica.

　3) The time course of advance of linitis plastica was composed of slow and fast phases. In three cases, the remarkable narrowing occurred in only one month. The narrowing did not occur all through the stomach at the same time, but in a part of stomach, especially in the corpus. It extended markedly in a short period.

　4) For detection of a primary lesion of linitis plastica, it was necessary to find the depressed lesions which were present between the folds of the corpus. In order to find the lesions, double contrast study with large volume of air and cautious compression study were very valuable.

　5) In the x-ray examination of the stomach of the youth and women efforts should be directed to the detection of lesions in the corpus.