胃と腸47巻4号

2012年04月発行

今月の主題 消化管EUS診断の現状と新たな展開 主題

消化管病変に対するEUS-FNAの適応と実際―消化管粘膜下病変および腫大リンパ節に対するEUS-FNA

著者： 入澤篤志¹² 引地拓人³ 佐藤匡記⁴ 澁川悟朗¹² 高木忠之⁴ 佐藤愛⁴ 池田恒彦⁴ 鈴木玲⁴ 中村純⁴ 渡辺晃⁴ 阿部洋子¹² 二階堂暁子¹² 小原勝敏³ 大平弘正⁴

所属機関： ¹福島県立医科大学会津医療センター準備室（消化器内科） ²福島県立会津総合病院消化器内科 ³福島県立医科大学附属病院内視鏡診療部 ⁴福島県立医科大学医学部消化器リウマチ膠原病内科学講座

ページ範囲：P.527 - P.537

要旨　消化管病変に対する超音波内視鏡下穿刺吸引生検法（EUS-FNA）は，消化管粘膜下病変（gastrointestinal submucosal lesion ; GI-SML）の質的診断や消化管癌の進展度診断（リンパ節転移の評価など）を適応とし，治療方針決定に有用な情報を与える．20mm以上のGI-SMLに対するFNAの正診率は，ばらつきはあるものの90％前後の報告が多く，高い有用性が示されている．また，縦隔や腹腔内の腫大リンパ節診断においては，総じて90％以上の成績が報告されている．検診が発達しているわが国においては，GI-SMLの発見率が高いことも相俟って，消化管病変に対するEUS-FNAの役割は今後さらにその重要性を増すものと思われる．

参考文献

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