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 主題研究

Helicobacter pylori除菌によって何が変わるのか?―胃酸分泌の変化

著者： 飯島克則¹ 小池智幸¹ 荒誠之¹ 宇野要¹ 浅野直喜¹ 下瀬川徹¹ 阿部靖彦² 関根仁³ 大原秀一⁴

所属機関： ¹東北大学病院消化器内科 ²山形大学病院消化器内科 ³仙台市立病院消化器内科 ⁴東北労災病院消化器内科

ページ範囲：P.1663 - P.1670

要旨　H. pylori除菌治療が普及するにつれ，除菌後に発生する胃癌に対する対策が必要である．筆者らはCongo red色素内視鏡検査を用いて，萎縮性胃炎患者におけるH. pylori除菌前後の胃酸分泌領域の変化を検討し，除菌によって胃酸分泌領域の拡大することを認めた．しかし，除菌後数年を経過した時点でも非酸分泌領域が残存し，機能的に酸分泌が回復しない領域は，高い細胞増殖能を有し，除菌後胃癌の発生母地となる可能性を示していた．また，実際に発生した除菌後胃癌19病変はすべて非酸分泌領域から発生していた．非酸分泌領域の分布，大きさを確認することで，除菌後胃癌の好発部位，リスクを評価することが可能と考えられる．

参考文献

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