胃と腸47巻11号

2012年10月発行

今月の主題 Helicobacter pylori除菌後の胃癌 主題

Helicobacter pylori除菌後の胃癌の特徴―臨床の立場から

著者： 加藤元嗣¹ 小野尚子¹ 森康明¹ 中川学¹ 間部克裕¹ 工藤俊彦¹ 中川宗一¹ 大野正芳² 石垣沙織² 鈴木美櫻² 高橋正和² 清水勇一² 坂本直哉² 山本桂子³

所属機関： ¹北海道大学病院光学医療診療部 ²北海道大学病院消化器内科 ³恵佑会札幌病院消化器内科

ページ範囲：P.1640 - P.1648

要旨　H. pylori感染は胃癌発症に重要な役割を担っている．わが国の大規模無作為試験により，H. pylori除菌が胃癌予防効果を有することが証明されたが，臨床的には除菌成功後に発見される胃癌をしばしば経験する．除菌後に発見される胃癌の特徴についての検討は十分ではない．除菌後胃癌はサイズが小さく，肉眼分類では陥凹型病変が多い．また，粘液形質では胃型あるいは胃型優位の混合型が多い特徴がある．除菌後に発見される胃癌は，感染下で発生する胃癌とは異なる性質をもっており，除菌によって胃癌の発育過程での，腫瘍の増殖抑制，腸型化の抑制，酸分泌亢進による影響を受ける可能性が考えられた．さらに，除菌後も長期間にわたって胃癌リスクが継続するため，除菌後の経過観察は重要である．

参考文献

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