胃と腸45巻5号

2010年04月発行

特集 早期大腸癌2010 主題 6．早期大腸癌の精密画像診断

5）画像強調・拡大観察―NBI

著者： 大庭さやか¹ 田中信治¹ 松本亜希² 金尾浩幸² 岡志郎¹ 吉田成人¹ 日山亨³ 上野義隆¹ 伊藤公訓² 北台靖彦² 吉原正治³ 茶山一彰²

所属機関： ¹広島大学内視鏡診療科 ²広島大学消化器･代謝内科 ³広島大学保健管理センター

ページ範囲：P.829 - P.840

要旨　NBI（narrow band imaging）拡大観察は，粘膜表層の微小血管構築の詳細な観察を可能にした．大腸腫瘍性病変に対するNBI拡大観察の臨床的意義は，まず病変拾い上げ診断に対する有用性であるが，肯定・否定両報告が複数あり，一定のコンセンサスが得られていない．一方，腫瘍・非腫瘍の鑑別診断における有用性は世界的にコンセンサスが得られている．また，色素を用いず整～軽度不整pit様構造（II，III，IV型，V_I軽度不整）を間接的に診断できるというメリットは診療の簡便化に有用である．微小血管構築とpit様構造を総合的に評価することで，早期大腸癌の深達度診断が可能である．しかし，早期癌の深達度診断に用いるNBI拡大観察所見分類が乱立しており，全国的な統一が必要である．

参考文献

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21）Hirata M, Tanaka S, Oka S, et al. Evaluation of microvessels in colorectal tumors by narrow band imaging magnification. Gastrointest Endosc 66 : 945-952, 2007

22）Kanao H, Tanaka S, Oka S, et al. Narrow-band imaging magnification predicts the histology and invasion depth of colorectal tumors. Gastrointest Endosc 69 : 631-636, 2009

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26）樫田博史，和田祥城，三澤将史，他．大腸癌の質的・量的診断─NBI拡大観察 : 昭和大学横浜市北部病院分類（昭和分類）─vascular patternによる腫瘍・非腫瘍，深達度診断の有用性．INTESTINE 13 : 202-208, 2009

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