胃と腸57巻13号

2022年12月発行

今月の主題 IEEを使いこなす

主題

NBIおよびBLIを使いこなす—咽頭・食道

著者： 田中一平¹ 平澤大¹ 五十嵐公洋¹ 名和田義高¹ 伊藤聡司¹ 赤平純一² 藤島史喜³ 松田知己¹

所属機関： ¹仙台厚生病院消化器内科 ²仙台厚生病院病理診断・臨床検査科 ³東北大学病院病理部

ページ範囲：P.1627 - P.1636

文献概要

要旨●現在NBIやBLIなどのIEE観察は，白色光観察や色素観察に加えて重要な内視鏡観察法の一つとなっている．特に咽頭・食道領域におけるIEE観察の有用性に関してはエビデンスが多数蓄積されている．今回筆者らは，白色光観察，NBI観察，色素（ヨード染色）観察における食道表在癌の視認性をスコアリングして評価した．2020年1月〜2021年12月の期間に当院で内視鏡的粘膜下層剝離術（ESD）が施行された食道扁平上皮癌81例81病変を対象とした．視認性の評価に関しては以下のスコアリングシステムを用いた．5：極めて明瞭に病変を認識できる，4：良好に病変を認識できる，3：病変の認識可能，2：病変の認識がやや難しい，1：病変の認識が困難である．白色光，NBI，ヨード染色，それぞれの平均スコアを算出し，Mann-Whitney U検定で有意差の比較を行った．結果，白色光，NBI，ヨード染色の平均視認性スコアはそれぞれ2.6±0.9，3.4±0.8，4.2±0.9であり，白色光観察<NBI観察<ヨード染色の順に視認性は有意に向上した．しかし，まだら食道に発生した病変や上方分化傾向を示す食道扁平上皮癌は，ヨード染色よりもNBIで視認性が向上する可能性が考えられた．

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