胃と腸53巻5号

2018年05月発行

増刊号 早期胃癌2018 主題

リスク層別化に基づく早期胃癌に対するサーベイランス

著者： 七條智聖¹ 上堂文也¹ 中川健太郎¹ 大森正泰¹ 荒尾真道¹ 岩坪太郎¹ 岩上裕吉¹ 松野健司¹ 井上俊太郎¹ 松浦倫子¹ 中平博子¹ 前川聡¹ 金坂卓¹ 竹内洋司¹ 東野晃治¹ 石原立¹

所属機関： ¹大阪国際がんセンター消化管内科

ページ範囲：P.726 - P.736

要旨●胃癌リスクとしては，Helicobacter pylori（H. pylori）感染，萎縮，腸上皮化生が知られている．リスク層別化の方法としては，血清H. pylori抗体と血清pepsinogenを用いたABC分類，組織学的な萎縮や腸上皮化生，内視鏡的萎縮が報告されている．萎縮以外の内視鏡所見によるリスク分類は，近年提唱された京都分類を中心に検討されているところである．除菌療法が保険適用となり，その普及に伴い除菌後のリスク層別化が重要となるが，内視鏡的萎縮がリスク因子となることが報告されている．また，高リスク群に対する画像強調観察法による早期胃癌拾い上げの有用性が前向き比較試験で検討されている．一方で，リスクに応じた検査間隔の確立が急務である．

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