胃癌および異型上皮巣の内視鏡的レーザー治療に関する研究

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  • CLINICAL STUDY OF ENDOSCOPIC LASER TREATMENT FOR GASTRIC CANCER AND ATYPICAL EPITHELIUM

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We investigated clinical application of the laser treatment in 17 lesions of gastric cancer and 7 lesions of atypical epithelium. Twenty lesions were attempted to treat curatively and ten lesions of them disappeared successfully with this method. All the lesions were less than 1.5 cm in size and cancerous infiltration was limited to the mucosal layer. Histologically, in nine lesions which were irradiated before operation, the mucosal layer and the lamina muscularis mucosae disappeared and the submucosal layer was changed into the necrotic tissue in various degrees. A part of the proper muscular layer was destroyed in three cases. Thirty cases (8.5%) in 351 cases of solitaly early gastric cancer accompanied the lymph node metastasis in our institute. In two cases out of them cancerous tissue was located in the mucosal layer and these lesions were diagnosed as a IIc type early cancer with ulcer scar, respectively. The lesions which are feasible to be cured completely by the laser irradiation are thought to be those less than 2 cm in diameter, limited to the mucosal layer and of the protruded type or the depressed type without ulceration or ulcer scar. In two cases lesions increased the volume within a half year of irradiation. In one case the lesion grew up to the same size as seen before the irradiation one year and nine months later.

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