胃と腸58巻3号

2023年03月発行

今月の主題 食道ESD瘢痕近傍病変の診断と治療 主題

食道扁平上皮癌に対する内視鏡的切除後に発生する異時性多発癌の危険因子—Japan Esophageal Cohort（JEC）studyから明らかにされたこと

著者： 堅田親利¹ 横山徹爾² 矢野友規³ 鈴木晴久⁴ 古江康明⁵ 石川秀樹⁶ 横山顕⁷ 横山顕礼¹ 玉置将司¹ 三谷洋介¹ 近藤雄紀¹ 清水孝洋⁸ 二階堂光洋⁸ 岸本曜⁹ 加納孝一¹⁰ 林隆一¹¹ 大橋真也¹ 武藤学¹

所属機関： ¹京都大学医学部附属病院腫瘍内科 ²国立保健医療科学院生涯健康研究部 ³国立がん研究センター東病院消化管内視鏡科 ⁴国立がん研究センター中央病院内視鏡科 ⁵北里大学医学部消化器内科学 ⁶京都府立医科大学分子標的予防医学 ⁷国立病院機構久里浜医療センター臨床研究部 ⁸京都大学医学部附属病院消化器内科 ⁹京都大学医学部附属病院耳鼻咽喉科・頭頸部外科 ¹⁰北里大学医学部耳鼻咽喉科・頭頸部外科学 ¹¹国立がん研究センター東病院頭頸部外科

ページ範囲：P.253 - P.258

要旨●食道扁平上皮癌は同時性または異時性に多発する．JEC試験は，食道扁平上皮癌の内視鏡的切除後に，6か月ごとの上部消化管内視鏡検査と12か月ごとの耳鼻咽喉科診察を継続しながら経過観察する前向きコホート研究である．330例が登録され，5年累積異時性食道癌発生率は約26%，累積異時性頭頸部癌発生率は約7%であった．内視鏡的切除後に異時性食道癌または異時性頭頸部癌が発生するリスクと相関のあるものとして，アルコール代謝関連酵素の遺伝子多型，食道癌リスク検診問診票の点数，アルコール使用障害特定テストの点数，平均赤血球容積，食道粘膜のヨード不染帯の程度がある．禁酒と禁煙は異時性食道癌発生のリスクを減少させる．

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