각종 위질환에 있어서의 위점막 장형화생과 위산도와의 관계에 관한 연구

Abstract

Intestinal metaplasia of the gastric mucosa has been long recognized, but the relationship between the metaplasia and the gastric acidity has been little recorded. In order to observe the influence of the frequency and the degree of mucosal metaplasia upon the gastric acidity. the author reviewed 111 resected stomach specimens on the basis of gastric juice analysis and pathologic aspect. The cases observed were 48 cases of gastric tumor, 44 of gastric ulcer , 14 of duodenal ulcer and 5 of chronic gastritis. The results obtained are as follows: 1) Of a total of 111 cases , 55.8% ~howed mild to severe intestinal metaplasia of the gastric mucosa, which were 62.5% in gastric tumors. 56.8% gastric ulcers, 21.4% in duodenal ulcers and 80.0% in chronic gastrities. 2) The frequency of intestinal metaplasia of the gastric mucosa as to the gastric acidity was 76. 4% in hypoacidity, 69.4% in anacidity, 43.7% in normoacldity and 30.0% in hyperacidity respectively: while in gastric tumors. 75.0% of hypoacldity cases , 64.5% of anacidity cases.50% of hyperacidity cases, and none of normoacidity cases; in gastric ulcers , 75.0% of hypoacidity cases , 100% of anacidity cases. 54.5% of normoacidity case~ and 40.0% of hyperacldity cases; in duodenal ulcers. 27.2% of normoacidity cases and none of other acidity cases; and in chronic gastrltes. 100% of hypo-and anacidity cases. As for the Grade n- m metaplasia. there were 66.6% of hypoacidity cases , 48.3% anacidity cases, none of normo-and hyperacidity cases in gastric tumors: 75.0% of hypoacidity cases , 48.4% of normoacidity cases , 40.0% of hyperacidity and none of anacidity cases in gastric ulcers; 18.1% of normoacldity cases in duodenal ulcers; and 100% of hypoand anacidity cases in chronic gastrites. 3) It is, therefore. apparent that the frequency of intestinal metaplasia of the gastric mucosa increases in accordance with the decrease of the gastric acidity, irrespective of primary disease of the stomach; and the degree of metaplasia is also roughly corelated with the decrease of the gastric acidity. but not proportional to variety of acidity. 4) It would thus appear that one of factors respo nsible to decrease of the gastric acidity in gastric diseases could be ascribed to the corresponding presence of the intestinalization of the gastric mucosa.