胃と腸40巻1号

2005年01月発行

今月の主題 胃癌の時代的変遷と将来展望 主題研究

センチネルリンパ節生検による新しい早期胃癌治療への取り組み―術中リンパ節転移陰性診断の意義

著者： 大谷吉秀¹ 北川雄光¹ 久保田哲朗¹ 吉田昌¹ 才川義朗¹ 赤津友佳子¹ 高橋常浩¹ 杉野吉則² 亀山香織³ 向井萬起男³ 熊井浩一郎⁴ 久保敦司² 北島政樹¹

所属機関： ¹慶應義塾大学医学部外科 ²慶應義塾大学医学部放射線科 ³慶應義塾大学医学部病理 ⁴慶應義塾大学医学部内視鏡センター

ページ範囲：P.112 - P.118

要旨　早期胃癌症例の増加により，より術後QOLを重視した治療法が選択される機会が増加している．早期胃癌の中でもリンパ節転移を有する約10％の症例を高い精度の方法で選別することで，より多くの患者がQOLに視点を置いた治療の恩恵を受けることができる．術中sentinel node（SN）生検は，腫瘍から最初のリンパ流を受けるリンパ節に微小転移が初発するという概念に基づいて，術中リンパ節生検を行ってリンパ節転移診断を行うというものである．SN生検が有用であるとする臨床経験の報告は少なくないが，一般臨床に用いるためには，より普遍性が高く臨床応用可能な方法の確立が求められる．現在2つの臨床試験が進行中であり，今後の展開が期待される．

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