胃と腸45巻13号

2010年12月発行

今月の主題 遺伝性消化管疾患の特徴と長期経過

主題

家族性大腸腺腫症における平坦陥凹型腫瘍―病理の立場から

著者： 藤盛孝博¹ 田中宏幸¹² 廣瀬元彦¹³ 藤盛友佳理¹⁴ 鈴木克昌¹⁴ 新井英樹⁴ 博多裕子¹⁵ 山岸秀嗣¹ 市川一仁¹ 冨田茂樹¹ 井村穣二¹ 大竹真一郎⁶ 佐藤英章⁷ 佐野寧⁸ 五十嵐良典³ 安田是和²

所属機関： ¹獨協医科大学病理学（人体分子） ²自治医科大学消化器・一般外科 ³東邦大学医療センター大森病院消化器内科 ⁴けいなん総合病院 ⁵獨協医科大学口腔外科 ⁶平塚胃腸病院附属池袋藤久ビルクリニック ⁷済生会川口総合病院病理診断科 ⁸医療法人薫風会佐野病院

ページ範囲：P.2049 - P.2058

文献概要

要旨　本稿では，（1）FAPと腫瘍発生に対する病理学の立場からの疑問，（2）FAP関連用語と類縁疾患，（3）大腸腫瘍の肉眼型とAPC遺伝子以外の遺伝子異常，（4）FAPと平坦陥凹型腫瘍についての文献的考察をまとめた．FAPであっても散発性大腸腺腫であってもWnt signal pathwayの異常から腺腫が発生する．腫瘍が発生したあと，どのような形態をとるかは，次の遺伝子異常へのステップが関与する．FAPにおいても平坦陥凹型腫瘍は生じる．ただし，微小，小腺腫ではなくSM癌や1cm以上の腫瘍が平坦陥凹型である頻度は，FAPにおいて非常にまれであると言える．また，FAPにおける平坦陥凹型腫瘍の定義や関与遺伝子の異常を検索する手段は文献により様々であることから，その違いを理解したうえで参考にする必要がある．

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