{"created":"2021-03-01T06:15:27.110661+00:00","id":11258,"links":{},"metadata":{"_buckets":{"deposit":"8ae40f70-7d92-4658-9f81-8f2f102c1ff8"},"_deposit":{"id":"11258","owners":[],"pid":{"revision_id":0,"type":"depid","value":"11258"},"status":"published"},"_oai":{"id":"oai:niigata-u.repo.nii.ac.jp:00011258","sets":["453:456","471:537:538:992"]},"item_7_alternative_title_1":{"attribute_name":"その他のタイトル","attribute_value_mlt":[{"subitem_alternative_title":"Clinicopathological Study of Asymptomatic Gastric Cancer and Symptomatic Gastric Cancer"}]},"item_7_biblio_info_6":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2008-04","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"4","bibliographicPageEnd":"183","bibliographicPageStart":"176","bibliographicVolumeNumber":"122","bibliographic_titles":[{"bibliographic_title":"新潟医学会雑誌"},{"bibliographic_title":"新潟医学会雑誌","bibliographic_titleLang":"en"}]}]},"item_7_description_4":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"胃がんは,その発見経緯から,無症状の時期に検診や外来でのスクリーニング検査で発見される無症状胃がん(asymptomatic gastric cancer:AGC)と症状を経緯にして発見される有症状胃がん(symptomatic gastric cancer:SGC)の2つに分類される.胃がん死亡を減少させるための診断戦略を考える際,両者の臨床病理学的特徴や予後を分析することは重要である.従来,外科切除例を対象として,両者を検討した報告はみれるが,胃がん全体を対象とした報告はみられない.そこで,今回,外科切除例以外も含め,全ての胃がんを対象にし,両者の臨床病理学的特徴と予後について検討した.対象は1997年1月から1999年12月まで,厚生連長岡中央綜合病院病歴室に登録された胃がん562例である.胃がん発見時の症状の有無は診療録の記載に拠って判定した.臨床病理学的特徴は,切除胃の病理学的所見,術中肉眼所見,胃内視鏡及び生検所見,胃X線所見,CT所見,超音波所見などに拠って判定した.生存率は治療のための入院日を起算日とし,これより5年経過後の生存の有無,死亡の場合はその年月日及び原病死か否かを追跡調査し算出した.AGCとSGCの頻度はそれぞれ,239例,323例であった.AGCは,SGCに比べ,男性の割合,早期がん率,検診発見率,内視鏡的切除率,手術例での治癒切除率,肉眼型が0型の割合,組織学的に分化型の割合,stageIの割合が有意に高かった.一方,SGCは,腫瘍の広範な進展のため化学療法や支持療法のみになった割合,肉眼型が2,3,4型の割合,腫瘍が胃全体を占める割合,stageII,III,IVの割合が有意に高かった.全死因を含む5年生存率は,AGC83.3%,SGC41.2%であり,AGCで有意に高かった.進行度別の5年生存率は,早期がんではAGC90.1%,SGC83.7%であり有意差はみられなかったが,進行がんではそれぞれ,38.7%,22.7%でありAGCで有意に高かった.SGCはAGCに比べ臨床病理学的に進行したものが多く,また,対象全体の40.0%を占めていたSGC進行がんの5年生存率が22.7%と低いことを考えると,胃がん死亡を減少させるためには,無症状のうちに検診またはスクリーニング検査を行い,胃がんを発見することが重要と考えられた.","subitem_description_type":"Abstract"},{"subitem_description":"Gastric cancer can be classified into two categories based on the absence or presence of symptoms at diagnosis. Differences in clinicopathological features and prognoses between asymptomatic gastric cancer (ACG) and symptomatic gastric cancer (SGC) can be used to inform diagnosis strategies and ultimately improve survival rates. All cases of gastric cancer (239 AGC, 323 SGC) diagnosed in our hospital between 1997 and 1999 were used in this study. ACG patients showed significantly higher frequency of males, cases of early cancer, cases found by a mass screening program, cases treated by endoscopic resection, cases treated by curative operation, cases of type 0 macroscopic finding, cases of histologically - differentiated type, and stage I cases. By contrast, SGC patients showed significantly higher numbers of cases treated by chemotherapy alone or best support care, cases of type 2, 3, and 4 macroscopic findings, cases occupying the whole stomach, and cases of stage II , III , N . Statistically significant differences were also found for the 5 - year survival rate (83.3 % in AGC, 41.2 % in SGC), the incidence of early cancer (90.1 % in AGC, 83.7 % in SGC) , and for advanced cancer (38.7 % in AGC, 22.7 % in SGC). The higher incidence of advanced cases in SGC than in AGC (40.0 % vs. 13.0 %), coupled with the low 5 - year survival rate of advanced SGC (22.7 %), provides strong evidence of the importance of diagnosing gastric cancer during its asymptomatic period.","subitem_description_type":"Abstract"}]},"item_7_full_name_3":{"attribute_name":"著者別名","attribute_value_mlt":[{"nameIdentifiers":[{"nameIdentifier":"76653","nameIdentifierScheme":"WEKO"}],"names":[{"name":"Sato, Toshiteru"}]}]},"item_7_publisher_7":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"新潟医学会"}]},"item_7_rights_15":{"attribute_name":"権利","attribute_value_mlt":[{"subitem_rights":"本文データは学協会の許諾に基づきCiNiiから複製したものである"}]},"item_7_select_19":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_select_item":"publisher"}]},"item_7_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AN00182415","subitem_source_identifier_type":"NCID"}]},"item_7_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"00290440","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"佐藤, 敏輝"}],"nameIdentifiers":[{"nameIdentifier":"76652","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2019-08-06"}],"displaytype":"detail","filename":"110007146512.pdf","filesize":[{"value":"673.4 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"110007146512.pdf","url":"https://niigata-u.repo.nii.ac.jp/record/11258/files/110007146512.pdf"},"version_id":"e20e8202-f71f-43a8-87b5-3416015cfa20"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"gastric cancer","subitem_subject_scheme":"Other"},{"subitem_subject":"asymptomatic","subitem_subject_scheme":"Other"},{"subitem_subject":"symptomatic","subitem_subject_scheme":"Other"},{"subitem_subject":"prognosis","subitem_subject_scheme":"Other"},{"subitem_subject":"clinicopathological study","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"無症状胃がんと有症状胃がんの臨床病理学的検討","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"無症状胃がんと有症状胃がんの臨床病理学的検討"},{"subitem_title":"無症状胃がんと有症状胃がんの臨床病理学的検討","subitem_title_language":"en"}]},"item_type_id":"7","owner":"1","path":["456","992"],"pubdate":{"attribute_name":"公開日","attribute_value":"2012-09-28"},"publish_date":"2012-09-28","publish_status":"0","recid":"11258","relation_version_is_last":true,"title":["無症状胃がんと有症状胃がんの臨床病理学的検討"],"weko_creator_id":"1","weko_shared_id":null},"updated":"2022-12-15T03:44:41.757344+00:00"}