胃と腸54巻3号

2019年03月発行

今月の主題 咽頭・食道内視鏡拡大観察の基本と最新知見 主題

Barrett食道腺癌（表在癌）の拡大観察—基本と最新知見

著者： 郷田憲一¹ 島村勇人² 岩谷勇吾² 古橋広人³ 原裕子³ 土橋昭³ 陣内秀仁¹ 菅谷武史¹ 土田幸平¹ 富永圭一¹ 眞島雄一¹ 室久俊光¹ 飯島誠¹ 入澤篤志¹

所属機関： ¹獨協医科大学消化器内科 ²昭和大学江東豊洲病院消化器センター ³東京慈恵会医科大学内視鏡科

ページ範囲：P.365 - P.373

要旨●本邦においてBarrett食道腺癌は依然まれであるが，GERDの罹患率上昇に伴い，今後，Barrett食道および腺癌の増加が憂慮されている．進行したBarrett食道腺癌の予後は不良であり，内視鏡検査による早期発見が重要である．本邦ではBarrett食道腺癌の大多数が内視鏡観察の難しい食道胃接合部に局在する．よって，その早期発見には通常観察のコツと拡大観察を駆使した高い内視鏡診断に習熟する必要がある．本稿では，筆者らの経験と国内外の臨床研究成果に基づいたBarrett腺癌の早期発見に肝要と思われる基本テクニックから，最近提唱された日本食道学会Barrett拡大内視鏡分類までを解説したい．

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