胃と腸58巻2号

2023年02月発行

今月の主題 鋸歯状病変関連の早期大腸癌

主題

癌併存大腸SSLの内視鏡診断—通常内視鏡の立場から

著者： 川崎啓祐¹ 梅野淳嗣¹ 鳥巣剛弘¹ 永塚真²³ 蔵原晃一⁴ 大城由美⁵ 江頭信二郎⁴ 梁井俊一² 鳥谷洋右² 川床慎一郎¹⁶ 松野雄一¹ 冬野雄太¹ 藤岡審¹ 森山智彦¹⁷ 菅井有³ 松本主之²

所属機関： ¹九州大学大学院病態機能内科学 ²岩手医科大学医学部内科学講座消化器内科分野 ³岩手医科大学医学部病理診断学講座 ⁴松山赤十字病院胃腸センター ⁵松山赤十字病院病理診断科 ⁶九州大学大学院形態機能病理学 ⁷九州大学病院国際医療部

ページ範囲：P.129 - P.134

文献概要

要旨●過去13年間に当科および関連施設にて診断された癌併存大腸SSL 17例を対象とし，病理組織学的所見と対比可能であったSSLと癌の領域の内視鏡所見を遡及的に比較検討した．その結果，癌領域はSSL領域に比べ，発赤（癌領域64.7%/SSL領域0%，p<0.05），結節・顆粒状隆起（癌領域64.7%/SSL領域5.9%，p<0.05）が多くみられた．一方でSSL領域の色調は全例で同色調，ないし褪色調を呈した（癌領域35.3%/SSL領域100%，p<0.05）．以上より発赤，結節・顆粒状隆起の存在が癌併存SSLにおける癌領域の特徴的な所見であり，癌併存大腸SSLは通常内視鏡で診断できる可能性が示唆された．

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