胃と腸51巻6号

2016年05月発行

今月の主題 Helicobacter pylori除菌後発見胃癌の内視鏡的特徴

主題研究

ESD後除菌後胃癌とDNAメチル化異常

著者： 中島健¹ 前田将宏² 森源喜¹³ 浅田潔²⁴ 関根茂樹⁵ 島津太一⁶ 小田一郎¹ 吉永繁高¹ 鈴木晴久¹ 野中哲¹ 阿部清一郎¹ 牛島俊和² 斎藤豊¹

所属機関： ¹国立がん研究センター中央病院内視鏡科 ²国立がん研究センター研究所エピゲノム解析分野 ³長崎県壱岐病院内科 ⁴奈良医科大学第三内科 ⁵国立がん研究センター中央病院病理科 ⁶国立がん研究センター社会と健康研究センター予防研究部

ページ範囲：P.805 - P.813

文献概要

要旨●早期胃癌に対する粘膜下層剝離術（ESD）後の異時性多発胃癌リスクは，除菌により軽減するものの，0にはならず5年間の累積発生率は15％にも及ぶ．しかし，サーベイランスの方法を個別化するためのリスク評価方法はいまだ確立していない．横断研究により胃癌で認められるDNAメチル化異常は非癌部粘膜にも認め，その程度（メチル化レベル）は胃癌発生リスクと相関した．昨年，ESD後異時性多発胃癌において，メチル化レベルの発癌リスクマーカーとしての有用性が多施設前向き研究により示された．現在，H. pylori除菌後患者を対象とした多施設前向き研究が開始され，メチル化レベルによるリスク層別の実用化をめざしている．

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