臨床整形外科48巻9号

2013年09月発行

整形外科/知ってるつもり

骨転移の疼痛機序

著者： 若林弘樹¹ 米田俊之²

所属機関： ¹三重大学大学院医学系研究科整形外科学講座 ²インディアナ大学医学部血液・腫瘍学部門

ページ範囲：P.876 - P.880

■はじめに

　厚生労働省の統計によると昭和60年以降，悪性新生物が死亡原因の1位となっている．その原因は遠隔臓器への転移であるが，医療の向上に伴いがん患者の予後は改善してきている．一方で，直接には生命予後には関わらない骨転移患者数は年々増加している¹²⁾．骨転移は患者のquality of life(QOL)を著しく低下させる要因であり，その中に激しい疼痛がある．がん患者に伴う疼痛は持続的，あるいは再発性であり，疾患に伴う不安感も助長させてしまう．骨転移に伴う骨痛は頻度も高く，がんによる骨痛発生機序の解明はがん患者のQOLに必須である．骨転移巣での酸性環境に着目し，骨痛発生機序と酸感受性受容体の関与についてわれわれが得た知見を交えながら紹介する．

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