胃と腸45巻5号

2010年04月発行

特集 早期大腸癌2010

ノート 4．早期大腸癌の病理

大腸鋸歯状病変

著者： 江頭由太郎¹ 芥川寛¹ 枝川豪¹ 藤井基嗣¹ 西田司¹ 川上研² 村野実之² 梅垣英次² 樋口和秀² 谷川允彦³

所属機関： ¹大阪医科大学病理学教室 ²大阪医科大学第2内科 ³大阪医科大学一般・消化器外科

ページ範囲：P.720 - P.724

文献概要

要旨　大腸鋸歯状病変は，鋸歯状構造を呈する腺管からなる非腫瘍性あるいは腫瘍性の限局性病変で，以下に示す4種類のカテゴリーに分類される．（1）hyperplastic polyp，（2）sessile serrated polyp/sessile serrated adenoma，（3）traditional serrated adenoma，（4）serrated adenocarcinoma．serrated pathwayは従来のadenoma-carcinoma sequenceとは異なる，大腸鋸歯状病変を経由した発癌経路である．serrated pathwayが大腸癌発癌経路に占める割合は10～15％と考えられており，鋸歯状病変は大腸癌の前癌病変として，通常型の腺腫に次いで注目すべき疾患群である．しかしながら，大腸鋸歯状病変は用語の統一や診断基準の確立などの解決されていない問題点を残しており，今後さらなる検証が必要である．

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