胃と腸46巻9号

2011年08月発行

今月の主題 若年者の胃・十二指腸病変の特徴 主題

若年者胃癌の特徴―中高年に認める胃癌との相違─若年者胃癌のリスク

著者： 伊藤公訓¹ 北村正輔¹ 松尾泰治¹ 高田俊介² 保田智之¹ 佐野村洋次¹ 東山真¹ 岡志郎² 田中信治² 吉原正治³ 鎌田智有⁴ 春間賢⁴ 茶山一彰¹

所属機関： ¹広島大学病院消化器・代謝内科 ²広島大学病院内視鏡診療科 ³広島大学保健管理センター ⁴川崎医科大学内科学食道・胃腸科

ページ範囲：P.1325 - P.1332

要旨　29歳以下に発生する胃癌は全胃癌例中0.1％程度のまれな病態であり，そのほとんどが未分化型癌の組織像を呈する．その発症には，中高年の胃癌と同様，Helicobacter pylori感染が重要な役割を果たす．症例対照研究では，若年者胃癌におけるH. pylori感染のodds比は23.5と算出され，中高年胃癌におけるodds比より高値となる．若年層においてH. pylori感染者は徐々に減少傾向にあるが，たとえ若年者であっても感染者には萎縮性胃炎が既に存在し，胃癌の発生母地となる．特に結節性胃炎症例では，体部胃炎を伴い未分化型胃癌の高危険群として臨床的に重要である．

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