胃と腸42巻6号

2007年05月発行

今月の主題 Helicobacter pyloriと胃癌 主題研究

Helicobacter pyloriと噴門部癌

著者： 阿部靖彦¹ 大原秀一¹ 小池智幸¹ 猪股芳文² 浅沼清孝¹ 堀井享¹ 飯島克則¹ 今谷晃¹ 下瀬川徹¹

所属機関： ¹東北大学病院消化器内科 ²宮城県対がん協会がん検診センター

ページ範囲：P.1011 - P.1024

要旨　噴門部癌はBarrett腺癌とともに欧米で増加が報告されており，その病態には胃食道逆流症が強く関連し，H. pylori感染の関与は少ないと考えられている．しかし，噴門部癌の定義は必ずしも統一されておらず，H. pylori感染率および背景となる胃粘膜の胃炎様式，胃食道逆流症の頻度や程度などの大きな地域差も考慮する必要があり，H. pylori感染と噴門部癌の関連については未解決の部分が多い．本邦ではBarrett腺癌，噴門部癌いずれも頻度は低く，多数例での検討は困難な状況であるが，われわれの限られた検討では，噴門部癌は通常の非噴門部胃癌と同様，H. pylori感染による高度の胃粘膜萎縮，低酸状態を背景とするものの他に，H. pylori感染によらず胃酸分泌が十分維持されているもの，すなわちBarrett腺癌類似の病態を示すものが存在すると推測された．

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