食道・胃接合部微小胃癌の内視鏡診断と病理

抄録

Early-stage cancer located on the upper part of the stomach, especially near the esophagogastric junction, is still difficult to diagnose, and frequently undiscoverd until it is too late. Minute cancers so far discovered, in particular, are few in number, and much remains obscure about their morphology, , including such problems as strophic and metaplastic changes in the mucous membrane over the said area. We looked into diagnosis and morphology of minute cancers of the said region in patients encountered by us. Subjects consisted of 12 patients with early-stage gastric cancer the size of 2 cm or less in maximum diameter, a margin of which was within distance of 2 cm from the junction. Total 13 such lesions were found in them. Our findings were as follows : (1) Straight-view fibescope is more useful in observation snd biopsy of small lesions adjacent to the junction, while lateral-view fiberscope has slight advantages with small lesions off the junction, (2) of small, early-stage gastric cancers near the junction, those adjacent to the junction are frequently protuberant, and those off the junction tend to be concave, (3) the majority of small, early-stage gastric cancers near the junction are histologically highly differentiated.