臨牀消化器内科 Vol.27 No.9(2)


特集名 スキルス胃癌―診断・治療の現状と今後
題名 スキルス胃癌の病理学的特徴
発刊年月 2012年 08月
著者 大倉 康男 杏林大学医学部病理学教室
【 要旨 】 スキルス胃癌は肉眼所見による疾患名であったが，病態が明確にされるなかで，組織学的な疾患名に変わっている．すなわち，間質に高度の線維増生を示す胃癌であり，肉眼型を意味するものではない．スキルス胃癌の肉眼型は3型，4型が多く，組織型は低分化腺癌，印環細胞癌，中分化管状腺癌である．一方，linitis plastica型胃癌は線維増生が高度で，壁肥厚，内腔の狭小化を特徴とする癌であるが，その定義は確立されたものでなく，スキルス胃癌，4型胃癌との異同が研究者によって違いがみられている．本邦では中村による定義が用いられることが多く，その疾患概念，発育進展過程を概略した．また，スキルス胃癌，4型胃癌との違いを解説した．
Theme Diagnosis and Treatment of Scirrhous Gastric Cancer -- Current Status and Future Prospects
Title Pathological Characteristics of Scirrhous Gastric Cancer
Author Yasuo Ohkura Department of Pathology, Kyorin University School of Medicine
[ Summary ] Scirrhous gastric cancer was determined by examining macroscopic views in former times. However, it is now determined histologically. It is a diffuse infiltrative cancer with marked fibrous stroma. Most scirrhous gastric cancer manifests as type 3 or type 4 macroscopically. Histologically, this type of cancer consists of poorly differentiated adenocarcinoma, signet-ring cell carcinoma or moderately differentiated tubular adenocarcinoma.
Linitis plastica (LP) type gastric cancer is similarly a diffuse infiltrative cancer with marked fibrous stroma, exhibiting markedly thickened walls and narrowing of the lumen. However, in terms of definition, there are differences between scirrhous cancer, type 4 cancer and LP type cancer, as determined by researchers. Nakamuraʼs definition of LP type cancer is widely used in Japan. Therefore, disease concepts and developmental processes revealed by Nakamura are discussed. Differences between scirrhous cancer and type 4 cancer are commented on as well.
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