胃と腸46巻1号

2011年01月発行

今月の主題 多発胃癌─最新の知見を含めて 主題

EMR/ESD後の多発胃癌のサーベイランス

著者： 中島健¹ 菅原真樹¹² 小田一郎¹ 吉永繁高¹ 鈴木晴久¹ 野中哲¹ 坂本琢¹ 小田柿智之¹ 松本美野里¹ 曽絵里子¹ 谷内田達夫¹ 山田真善¹ 河俣浩之¹ 森源喜¹ 松田尚久¹ 斎藤豊¹

所属機関： ¹国立がん研究センター中央病院消化管内視鏡科 ²KKR札幌医療センター斗南病院消化器内科

ページ範囲：P.66 - P.74

要旨　早期胃癌に対する内視鏡的粘膜下層剝離術（ESD）は広く普及し，Helicobacter pylori除菌療法はその後の標準治療となった．今回当院でESD後除菌成功後に認めた異時性多発胃癌を検討した．2000年から2010年までのESD治癒切除症例で，その後H. pylori除菌療法成功後に異時性胃癌を認めたものが合計33例39病変存在した（2次癌33病変，3次癌6病変）．除菌後胃癌発見までの期間は平均28.8か月，中央値15.0か月（5～120か月），男女比 31/2，腫瘍径中央値12.3（3～30）mmであった．発見時検査と前回検査との間隔は平均8.5（5～19）か月であった．陥凹型で分化型の粘膜内癌の頻度が高く，高度萎縮粘膜の患者頻度が高かった．今後は長期経過例の症例蓄積が必要である．

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