胃と腸49巻10号

2014年09月発行

今月の主題 colitic cancerの初期病変─遡及例の検討を含めて 主題

注腸X線造影検査からみたcolitic cancerの初期病変―遡及例の検討を含めて

著者： 江㟢幹宏¹ 貫陽一郎¹ 河内修司² 梅野淳嗣¹ 前畠裕司¹ 浅野光一¹ 森山智彦¹ 中村昌太郎¹ 城由起彦³ 檜沢一興⁴ 蔵原晃一² 一瀬理沙⁵ 熊谷好晃⁵ 平橋美奈子⁵ 大城由美⁶ 松本主之⁷

所属機関： ¹九州大学大学院医学研究院病態機能内科学 ²松山赤十字病院胃腸センター ³祥知会はこざき公園内科医院 ⁴公立学校共済組合九州中央病院 ⁵九州大学大学院医学研究院形態機能病理学 ⁶松山赤十字病院病理診断科 ⁷岩手医科大学医学部内科学講座消化器内科消化管分野

ページ範囲：P.1423 - P.1434

要旨　寛解期潰瘍性大腸炎における潰瘍性大腸炎関連腫瘍（UCAN）と散発性腫瘍（SCA）の注腸X線造影所見を比較した．UCAN 15病変は9病変が表面型，6病変が隆起型であった．一方，SCA 6病変は表面型が4病変，隆起型が2病変であった．表面型を呈したUCANとSCAのそれぞれ2病変でバリウム斑を有していた．表面型UCANでは9病変のうち7病変で病変境界が不明瞭であったのに対し，表面型SCAでは4病変とも明瞭な病変境界を有していた（p＝0.02）．一方，隆起型腫瘍ではUCANはSCAに比べて隆起の大小不同が顕著であった．以上より，早期病変におけるUCANとSCAの鑑別には，X線造影像における病変境界所見と隆起の大小不同に着目することが有用と考えられた．

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