胃腺扁平上皮癌7例の検討 CLINICOPATHOLOGICAL SIGNIFICANCE ON ADENOSQUAMOUS CARCINOMA OF THE STOMACH : REPORT OF SEVEN CASES

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過去27年間に胃癌手術2,705症例を経験したが腺扁平上皮癌は7例, 0.3%であった.平均年齢61.6歳,男女比4:3.腫瘍の肉眼型は3型, 5例, 2型, 2例で,腫瘍径は4.0~12.0cm,平均8.3cmであった.漿膜面因子はT4が4例, T3, 2例. T2, 1例で, 7例中6例に肉眼的にリンパ節転移を認めたが,肝転移,腹膜播種はみられなかった. 4例に幽門側胃切除術が3例に全摘術が施行された.深達度はssが6例siが1例で,病理学的に6例にリンパ節転移を認めた.総合的進行程度はIb 1例, II 3例, IIIa 2例, IIIb 1例であった.予後は7例中4例が術後3年以内に再発死亡し, 2例が術後8年以上生存, 1例が術後3年の現在生存中である.本症は腫瘍径が小さくても十分なリンパ節郭清が必要であるが,逆に巨大例に対しては他臓器浸潤のため治癒切除困難例でも組織学的にはss以下の症例が多く,可能な限り治癒切除を目指すことが肝要である.

A series of 2, 705 cases of gastric cancer were operated at the department in a past 27-year period and adenosquamous cell carcinomas represented 0.3% (seven cases) of all the gastric cancers. These seven cases were clinicopathologically studied. The male-to-female ratio was 4 to 3 and an average age was 61.6 years. (1) In terms of macroscopic type, type III was observed in 5 cases and type II in 2 cases. (2) Mean diameter of the tumors was 8.3cm (4.012.0cm). (3) Four patients underwent a distal gastrectomy and three total gastrectomy. (4) Histologically lymph node metastasis was observed in 6 cases. While neither liver metastasis nor peritoneal dissemination was noted. (5) As to the depth of invasion of the tumor, subserosal invasion was observed in 6 cases and invasion to the adjacent organ only in one case. (6) Clinical staging was rated as Ib in one case, II in three cases, IIIa in two cases and IIIb in one case. (7) Four out of seven patients died of recurrence within 3 years, two patients are alive more than 8 years and one patient is also alive 3 years after operation. Five-year survival rate was 42.9%. In conclusion, the adenosquamous cell carcinoma of the stomach demands extended radical operation not only for cases of small tumor but for cases of huge tumor, because even those tumors incapable of undergoing a curative resection are often histologically ss or less due to invasion into the adjacent organs.

収録刊行物

  • 日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society

    日本臨床外科医学会雑誌 = The journal of the Japanese Practical Surgeon Society 58(6), 1265-1269, 1997-06-25

    Japan Surgical Association

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各種コード

  • NII論文ID(NAID)
    10008527956
  • NII書誌ID(NCID)
    AN00198696
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    03869776
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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