胃と腸59巻6号

2024年06月発行

今月の主題 内視鏡治療後サーベイランスの現状—異時性多発病変を中心に

主題

胃腫瘍の内視鏡治療後サーベイランス

著者： 魚住健志¹ 関口正宇¹² 水口康彦¹ 野中哲¹ 阿部清一郎¹ 鈴木晴久¹³ 斎藤豊¹

所属機関： ¹国立がん研究センター中央病院内視鏡科 ²国立がん研究センター中央病院検診センター ³日本大学医学部附属板橋病院消化器・肝臓内科

ページ範囲：P.829 - P.839

文献概要

要旨●早期胃癌内視鏡治療後の異時性多発胃癌の発生率は年率3.5%と報告されており，初回内視鏡治療から5年以上経過後も累積胃癌発生率は経時的に上昇する．初回内視鏡治療がeCura Aであっても，その後に外科的胃切除が必要な異時性多発胃癌が発見される症例や転移性胃癌で死亡する症例も存在する．内視鏡治療後は5年経過後も可能な限りサーベイランスを継続し，異時性多発胃癌を早期に発見するのが望ましい．近年，高齢胃癌患者を診療する機会や，H. pylori除菌療法の普及に伴う除菌後胃癌およびH. pylori未感染胃癌に遭遇する機会が増えている．胃癌を取り巻く環境は大きく変化しており，これまで内視鏡治療後に一律に行われていたサーベイランスのあり方を見直す時期が来ている．

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