胃と腸38巻1号

2003年01月発行

今月の主題 胃癌―診断と治療の最先端

主題

胃型・腸型腺癌の特性

著者： 遠藤泰志¹ 渡辺英伸² 本山悌一³ 落合淳志⁴

所属機関： ¹国立がんセンター東病院臨床検査部細胞検査室 ²新潟大学大学院医歯学総合研究科分子・診断病理学 ³山形大学医学部病理学第二講座 ⁴国立がんセンター研究所支所臨床腫瘍病理

ページ範囲：P.57 - P.65

文献概要

　胃型と腸型の分化型癌は，臨床病理学的にも分子生物学的にも，大きく異なる特性を有する腫瘍であることが判明しつつある．胃型分化型癌は低分化癌化傾向が高く，これにはE-cadherinの異常の関与が大きい．またhMLH1遺伝子のメチル化とmicrosatellite instabilityが高頻度に生じており，組織発生への関与が示唆されている．生物学的悪性度も通常型の分化型癌に比べて高い．一方，腸型分化型癌には，完全型腸上皮化生形質を強く有し，細胞異型は目立たず構造異型が病理組織診断の決め手となる一群があり，しばしば臨床病理学的に見逃され問題となる．この種の腸型分化型癌もやはり特徴的な臨床病理像を示す．これら胃型および腸型分化型癌の特性について，これまでの報告を踏まえ考察した．

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