胃と腸49巻6号

2014年05月発行

今月の主題 Helicobacter pylori陰性胃癌

主題

Helicobacter pylori陰性の胃底腺粘膜関連腫瘍―胃底腺型胃癌と胃底腺ポリープの腫瘍化

著者： 八尾隆史¹ 上山浩也² 上尾哲也³ 日高康博² 野村亮介²

所属機関： ¹順天堂大学大学院医学研究院人体病理病態学 ²順天堂大学医学部附属順天堂医院消化器内科 ³大分赤十字病院消化器内科

ページ範囲：P.874 - P.880

文献概要

要旨　胃底腺型胃癌は，Helicobacter pylori（H. pylori）と関連のない胃癌であり，低悪性度で予後良好な腫瘍と考えられていたが，高悪性度の病変も存在することが判明してきた．その発生および発育進展過程において，Wntシグナル系の活性化の関連やGNAS遺伝子変異との関連が示唆されているが，臨床的取り扱いに有用となる悪性度に関連した細胞学的および分子生物学的因子の解明が今後の課題である．胃底腺ポリープもH. pyloriと関連のない病変で，悪性の危険性はない病変とされていた．しかし，近年散発性のものでもβカテニンの遺伝子異常を認めることから腫瘍性である可能性が示唆され，まれではあるが腫瘍化した症例も報告されている．今後，H. pylori感染率が低下している中で，これら胃底腺粘膜関連病変に対して新たな視点をもって注目する必要がある．

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