| 特集名 | 拡大内視鏡による質的診断の進歩 -- VI型pitから血管構造・Endo-Cystoscopy・IBDまで | |
|---|---|---|
| 題名 | VI型pit patternにおける不整の程度と浸潤度 (3) 大腸腫瘍性病変における表面微細構造の検討 -- 画像解析への試み | |
| 発刊年月 | 2006年 05月 | |
| 著者 | 大日方 信幸 | 秋田赤十字病院消化器病センター／聖マリアンナ医科大学病院消化器肝臓内科 |
| 著者 | 山野 泰穂 | 秋田赤十字病院消化器病センター |
| 著者 | 松下 弘雄 | 秋田赤十字病院消化器病センター／健康保険人吉総合病院外科 |
| 著者 | 佐藤 健太郎 | 秋田赤十字病院消化器病センター |
| 著者 | 吉川 健二郎 | 秋田赤十字病院消化器病センター |
| 著者 | 小竹 理子 | 秋田赤十字病院消化器病センター |
| 著者 | 藤田 和彦 | 聖マリアンナ医科大学病院消化器肝臓内科 |
| 著者 | 伊東 文生 | 聖マリアンナ医科大学病院消化器肝臓内科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Development of diagnosis of magnifying endoscopy | |
|---|---|---|
| Title | Examination of surface microstructure of large intestinal tumors | |
| Author | Nobuyuki Obinata | Division of Gastroenterology, Akita Red Cross Hospital / Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine Hospital |
| Author | Hiro-o Yamano | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Hiro-o Matsushita | Division of Gastroenterology, Akita Red Cross Hospital / Division of Surgery, Health Insurance Hitoyoshi General Hospital |
| Author | Kentarou Satoh | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Kenjirou Yoshikawa | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Ayako Kotake | Division of Gastroenterology, Akita Red Cross Hospital |
| Author | Kazuhiko Fujita | Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine Hospital |
| Author | Fumio Itoh | Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine Hospital |
| [ Summary ] | Purpose : To objectively examine the surface microstructure with large intestinal tumors by image analysis. Subject : Lesions [e. g., laterally spreading non-granular tumor (LST NG)] that can be examined with sufficiently clear images, obtained using magnifying endoscopy, stereoscopic microscopy and light microscopy of histopathological specimens, were examined, along with large intestinal tumors, in patients treated at the Division of Gastroenterology, Akita Red Cross Hospital. Method : On the basis of the histopathological features observed with a light microscopy image, detected lesions were divided into three groups : severe atypical adenoma (hereafter, sev group), m and sm slight invasive carcinoma (m / sm-S group) and sm deep invasive carcinoma (sm-M group). The endoscopic and stereoscopic microscopy images of these lesions were analyzed using image-processing software (MacScope Ver. 2). The morphological characteristic values (the number of pits, size of lesion, complexity value and areas of pit per 1 mm2) as well as the statistical characteristic value [dye contrast value (staining intensity) reflecting depth of pit] were examined. Results : The morphological characteristic values are as follows : (1) Numbers of pits ; 68.0 (sev group), 40.6 (m / sm-S group), and 14.5 (sm-M group) (2) Sizes of lesions ; 0.44 x 10-2 mm2 (sev group), 0.48 x 10-2 mm2 (m / sm-S group), and 0.83 x 10-2 mm2 (sm-M group) (3) Complexity values ; 23.1 (sev group), 38.3 (m / sm-S group), and 46.8 (sm-M group) (4) Areas of pit per 1 mm2 ; 0.30 x 10-2 mm2 (sev group), 0.15 x 10-2 mm2 (m / sm-S group), and 0.11 x 10-2 mm2 (sm-M group). The statistical characteristic values are as follows : dye contrast values (depth of pit) ; 12.4 (sev group), 14.0 (m / sm-S group), and 8.59 (sm-M group). The pit depth of the sm-M group was deeper than those of the other two groups. Statistically significant differences were confirmed between the sm-M group and the sev and m / sm-S groups in all the results obtained in this study. Conclusions : The surface microstructure of large intestinal tumors was examined using image-analyzing software. Based on the morphological characteristic values and statistical characteristic values, an objective diagnosis is possible using a magnifying endoscope. We plan to report on the results of further examinations in the future. |
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