胃と腸51巻10号

2016年09月発行

今月の主題 表在型Barrett食道癌の診断

主題

表在型Barrett食道癌の転移・再発危険因子─第72回食道色素研究会多施設アンケート調査から

著者： 相田順子¹ 石崎達郎² 石渡俊行¹ 田久保海誉¹ 新井冨生³

所属機関： ¹東京都健康長寿医療センター研究所老年病理学研究チーム ²東京都健康長寿医療センター研究所福祉と生活ケア研究チーム ³東京都健康長寿医療センター病理診断科

ページ範囲：P.1269 - P.1282

文献概要

要旨●表在型Barrett食道癌は治療方針を決定する際，転移・再発の危険因子の把握が重要である．本稿では欧米の文献の評価と食道色素研究会で行った多施設アンケート調査の結果を合わせ，転移・再発の危険因子について記述した．欧米の文献では，腫瘍径20mm以内で，pT1a癌，高・中分化型腺癌で脈管侵襲のないものが“low risk”とされる．今回の集計結果ではさらに，浸潤様式INFc，また肉眼型0-I型はリンパ節転移の危険性が高かった．pT1b癌は，取扱い規約のSM1までで“low-risk”の症例は，内視鏡治療で根治可能と考えられた．今回の集計結果でリンパ管侵襲や再発の有無に差があることから，SM1の深さは500μmまでが適当と考えられた．

参考文献

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