進行胃癌肉眼分類の歴史とその適用

Macroscopic Classication of Advanced Gastric Cancer and its Application

要旨●進行胃癌の肉眼分類はBorrmannによって初めてなされ，現在もその分類が基礎となっている．当時は肉眼型と組織型の関連性はなされていないが，本稿では組織型とその浸潤形式の関連性について記載した．また当時からスキルスと肉眼分類の関係について多くの議論がなされてきたが，本稿ではそのスキルスに焦点を当ててその問題点を記載した．スキルスは本来硬い癌との意味であるが，歴史的には軟らかい癌も含まれていた時期があり，その多くは幽門部全周性に拡がった癌の一部と考えられていた．また4型胃癌の中でlinitis plasticaと記載されてきた癌の特徴についても歴史的観点からの変遷について述べた．

　Borrmann first described the macroscopic classification of advanced gastric cancer, which still serves as the basis today. Meanwhile, the association between macroscopic and histological types was not discussed, but this time, we described the relationship between histological type and its invasion mode. Since then, much discussion existed about the association between scirrhous cancer and macroscopic classification. However, this time, we focused on scirrhous cancer and described the problems. Scirrhous cancer originally meant hard cancer, but historically, it included soft cancers, many of which were considered part of cancer that had metastasized around the entire pylorus. Further, we described the historical changes in the characteristics of type 4 gastric cancer, which has been described as linitis plastica.