Teruhisa Shimizu

Signet ring cell early gastric cancer presenting as an elevated lesion.

SummaryEarly gastric cancer composed of signet ring cell carcinoma is usually present as a depressed lesion and rarely manifests as a protruding lesion. To our knowledge, only eight cases have been reported in the literature. We herein report such a rare lesion which developed in an asymptomatic 55-year-old man.

Surgical experience with 5 n3(+) early gastric carcinoma cases.

SummaryOf 370 patients who underwent a resection for early gastric carcinoma, 317 (85.6%) were N(-), 28 n1(+), 20 n2(+) and five (1.4%) n3 respectively. In this study, n3(+) early gastric cancers were clinicopathologically evaluated and sites of the metastatic nodes were also difined. In addition, a comparative study in DNA ploidy patterns between primary and metastatic node cells was performed according to Hedley’s method using a FACS-IV scan of paraffin-embedded tissues. All n3(+) early gastric cancers showed an aneuploidy pattern. R2 or R3 operations are recommended for early gastric carcinomas with aneuploidy pattern and most of the metastatic nodes arise from the identical stem cell line of cancer cells.

Colonic Lipoma Removed by Endoscopic Polypectomy:—A Report of Three Cases—

We report on three cases of colonic lipoma removed by endoscopic polypectomy. Patient 1 was a 46‐year‐old female, Patient 2 a 63‐year‐old male and Patient 3 a 76‐year‐old female, with their afflicted regions being the; ascending colon, ascending colon and transverse colon, respectively. All the three lipomas were pedunculated and smooth on the surface, with the subrnucosal figure presenting yellowish or reddish in color. In Patient 1 and Patient 2, both tumors were totally removed, and in Patient 3, a “half resection” of the polyp was performed by endoscopic polypectomy. The resected specimens were 1.5 cm, 2.6 cm and 1.0 cm, respectively, in size at their maximum diameter and soft tumors with uniformly yellow cut‐surfaces. All were histopathologically diagnosed as being “lipoma”. Because the colonic lipoma is benign, an endoscopic polypectomy should be tried as the treatment of choice in selected patients.

A Retrospective Clinicopathological Study on Adenocarcinoma of the Upper Part of the Stomach with Special Reference to Lymph Node Metastases

上部胃癌切除294例について, 占居部位・漿膜面浸潤・組織学的壁深達度別に所属リンパ節の転移を検索し, 術式の選択・適応について検討した.切除全胃癌中21.3%を占め, 男女比は2.7: 1, 平均年齢は60.0歳であった.胃癌取扱い規約によれば, Cに限局するものは129例で, 早期癌は15.0%であった.術式は胃全摘214例, 噴切52例, その他28例であった.リンパ節転移は, 早期癌ではn (-) であったが, pmで#2・3に7.7, 30%, ssβで#1・3に40%, #7・9に20%, #6・10・11・13・14に10%, ssγでは#4s・4d・16に37.5, 12.5, 12.5%の転移をみた.Cの漿膜面浸潤と#4d・5・6の転移は, S0S1はn (-) であったが, S2ではそれぞれ2.8, 11.1, 5.6%の転移をきたし, S3では21, 4, 14.2, 7.1%であった.5年および10年生存率は全摘で43.1%, 40.9%, 噴切で32, 5%, 27.5%で, 全摘が優れていたが有意差はなかった.以上より上部胃癌の噴切の適応はS1までのもの, 組織学的にはssγまでにとどまるものである.

The prognostic singnificance of cellular DNA content in colorectal cancer using multivariate analysis.

大腸癌核DNA量の予後因子としての価値を検討する目的で, Coxの比例ハザードモデルにより多変量解析を試みた. 方法はパラフィンブロックを用いたB.Schutteらの方法に準じflow cytometerで核DNA量を測定した. 236例中DNA diploidyは97例 (41.1%) であり, DNA aneuploidyは139例 (58.9%) であった. DNA ploidyは臨床病理学的因子の中で, 壁深達度, リンパ節転移との間に有意差を認め, Coxの比例ハザードモデルにおいては, 回帰係数β値は0.7739危険率0.0033であり, 他の病理組織学的因子に優る有意性が認められた. 以上の結果より, 大腸癌核DNA量は独立した予後因子として有用であることが明かとなった.