胃と腸49巻7号

2014年06月発行

今月の主題 大腸T1（SM）癌に対する内視鏡治療の適応拡大 主題

完全摘除生検可能な大腸T1（SM）深部浸潤癌の術前診断―超音波内視鏡

著者： 藤谷幹浩¹ 斉藤裕輔² 富永素矢² 盛一健太郎¹ 堂腰達矢¹ 田中一之¹ 坂谷慧¹ 藤林周吾¹ 安藤勝祥¹ 上野伸展¹ 後藤拓磨¹ 嘉島伸¹ 笹島順平¹ 伊藤貴博¹ 高後裕¹

所属機関： ¹旭川医科大学内科学講座消化器・血液腫瘍制御内科学分野 ²市立旭川病院消化器病センター

ページ範囲：P.1036 - P.1045

要旨　完全摘除生検可能な大腸SM深部浸潤癌の術前診断における超音波内視鏡検査の有用性について解説した．超音波内視鏡検査は大腸癌の浸潤を垂直断面として直接観察できる唯一の検査法であり，組織上のSM浸潤距離をよく反映した．しかし，3,000μm以上のSM浸潤になると，浸潤距離の診断能が下がる傾向にあった．また，SM癌の深達度診断能は高いものの，MP癌については満足いくものではなく，その主な原因は超音波の深部減衰と考えられた．今後，低周波数の超音波内視鏡検査の併用も考慮し，より深部に浸潤したSM癌の浸潤距離診断能を向上させることが必要である．

参考文献

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