胃と腸58巻9号

2023年09月発行

今月の主題 知っておくべき口腔・咽喉頭病変

主題

口腔表在癌の内視鏡診断

著者： 堅田親利¹ 樋口浩和² 岸本曜³ 清水孝洋⁴ 二階堂光洋⁴ 井上貴裕⁴ 横山顕礼¹ 玉置将司¹ 野村基雄¹ 三谷洋介¹ 近藤雄紀¹ 伊藤寛朗⁵ 南口早智子⁵ 羽賀博典⁵ 古江康明⁶ 細野浩史⁷ 加納孝一⁷ 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 ²京都大学医学部附属病院内視鏡部 ³京都大学医学部附属病院耳鼻咽喉科・頭頸部外科 ⁴京都大学医学部附属病院消化器内科 ⁵京都大学医学部附属病院病理診断科 ⁶北里大学病院消化器内科 ⁷北里大学病院耳鼻咽喉科・頭頸部外科

ページ範囲：P.1112 - P.1119

文献概要

要旨●世界における口腔癌の罹患数，死亡数は喉頭癌・中咽頭癌・下咽頭癌よりも多い．また，field cancerization現象として食道癌や頭頸部癌の治療前後に発生することをしばしば経験する．JEC試験は330例の食道癌内視鏡的切除例を対象に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．2年累積異時性頭頸部癌発生率は3.7%であり，耳鼻咽喉科診察により1例の口腔癌（硬口蓋）が表在癌で発見された．112例の食道癌患者を対象に頭頸部領域をNBI拡大内視鏡で観察する前向き研究では，3例の口腔癌（舌2，硬口蓋1）が表在癌で発見された．口腔癌の予後やQOL改善に貢献するためには，消化器内視鏡を用いた適切な口腔観察方法や早期診断を目的としたサーベイランス方法を確立する必要がある．

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