胃と腸49巻11号

2014年10月発行

今月の主題 胃癌ESD適応拡大病変の経過と予後 主題

胃癌ESD適応拡大病変（未分化型優位）の経過と予後

著者： 山本頼正¹ 藤崎順子¹ 宮本勇治¹ 清水智樹¹ 富田英臣¹ 谷口智香¹ 森重健次郎¹ 堀内裕介¹ 大前雅実¹ 由雄敏之¹ 平澤俊明¹ 石山晃世志¹ 土田知宏¹ 五十嵐正広¹

所属機関： ¹がん研有明病院消化器センター内科

ページ範囲：P.1569 - P.1577

要旨　近年，早期胃癌の内視鏡治療の適応は腫瘍径20mm以下，潰瘍なしの未分化型粘膜内癌にまで臨床研究として拡大されているが，その長期予後は明らかになっていない．今回，ESDを行った未分化型粘膜内癌の長期予後を検討した．109例にESDを行い，治癒切除率は81.7％，観察期間62.6か月（中央値）で原病死3例，他病死11例，5年全生存率，疾患特異的生存率は89.8％，96.9％であった．手術された未分化型適応拡大病変50例とESD治癒切除の89例を比較し，手術の5年全生存率，疾患特異的生存率はともに100％，ESDは90.9％，97.5％で有意差はなかった．未分化型適応拡大病変に対するESDは治療選択のひとつとなりえる．

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