胃と腸51巻1号

2016年01月発行

今月の主題 慢性胃炎を見直す 主題

胃炎の内視鏡診断─通常光観察

著者： 加藤元嗣¹ 小野尚子¹ 中川学¹ 中川宗一¹ 安孫子怜史² 宮本秀一² 水島健² 津田桃子² 大野正芳² 大西俊介² 清水勇一² 坂本直哉² 間部克裕³

所属機関： ¹北海道大学病院光学医療診療部 ²北海道大学消化器内科 ³北海道大学がん予防内科

ページ範囲：P.42 - P.51

要旨●組織学的所見と内視鏡所見が一致しないために，慢性胃炎はこれまで組織学的に診断されてきた．しかし，最近の内視鏡機器の進歩により，組織学的胃炎と一致する内視鏡所見が次第に明らかになった．胃粘膜におけるH. pylori感染状態は，H. pylori未感染，H. pylori感染，H. pylori既感染・除菌後に分けることができる．新たな内視鏡による胃炎分類である京都分類では，19の胃炎所見を定義して，H. pylori感染状態との関連性を整理した．RAC，びまん性発赤，地図状発赤は，それぞれH. pylori未感染，H. pylori感染，H. pylori除菌後の特徴的な所見である．H. pylori感染状態によって，発生胃癌のリスクや特徴は異なるため，胃炎の診断は胃癌スクリーニングにおいても重要である．

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