胃と腸57巻10号

2022年09月発行

今月の主題 大腸腫瘍診療の最前線 主題

画像強調大腸内視鏡検査の最前線—質的診断

著者： 佐野亙¹ 杉村直毅¹ 平田大善¹ 岩館峰雄¹ 服部三太¹ 藤田幹夫¹ 佐野寧¹

所属機関： ¹佐野病院消化器センター

ページ範囲：P.1243 - P.1250

要旨●現在，画像強調大腸内視鏡検査による質的診断は，非拡大白色光観察の時代から，色素拡大観察の時代を経て，NBI観察が主流の時代へと変遷した．このNBIを使った診断の指標として，本邦ではJNET分類が広く用いられている．これまでに報告されているJNET分類のvalidation studyの結果は概ね良好ではあるが，JNET Type 1の中には前癌病変であるSSL（sessile serrated lesion）が含まれること，陥凹型腺腫では通常の腺腫にみられるようなType 2Aの所見が観察されない場合もあること，Type 3では原則的に外科的切除が勧められるが，Type 2Bでは色素拡大観察の追加による深達度診断が必要であることに注意が必要である．

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