| 特集名 | 早期食道癌 -- 病型分類と深達度から | |
|---|---|---|
| 題名 | 早期食道癌の診断 (2) 内視鏡診断 a.病型分類と深達度診断(通常内視鏡の立場から) | |
| 発刊年月 | 1997年 11月 | |
| 著者 | 長南 明道 | JR仙台病院消化器内視鏡センター |
| 著者 | 望月 福治 | JR仙台病院消化器内視鏡センター |
| 【 要旨 】 | 通常内視鏡による食道表在癌の深達度診断について述べた．病型分類と深達度は密接に関わっており，基本的に0-IIb型はm1,0-IIa型は粘膜内に留まり(m1～m3)，0-I型，0-III型はsm癌である．一方，0-IIc型はm1～sm3まで広く分布しており，もっとも深達度診断が困難である．通常内視鏡による食道表在癌の深達度診断能をみると，深達度m1～m2では91%，sm2～sm3では83%が正診されていた．しかし，m3～sm1では正診率は37%にすぎず，X線所見，トルイジンブルーによる色素内視鏡所見，超音波内視鏡所見などを併せて診断していく必要がある． | |
| Theme | Early Esophageal cancer-from the Viewpoint of its Type and the Depth of Invasion | |
|---|---|---|
| Title | Endoscopic Diagnosis of The Depth of Invasion and Classification of Early Esophageal Cancer | |
| Author | Akimichi Chonan | Department of Gastroenterology, JR Sendai Hospital |
| Author | Fukuji Mochizuki | Department of Gastroenterology, JR Sendai Hospital |
| [ Summary ] | To estimate the depth of early esophageal cancer invasion, 74 patients with early esophageal cancer were examined endoscopically. Macroscopic type correlated with the depth of cancer invasion. Patients with 0-I (superficial and protruding) type and 0-III (superficial and distinctly depressed) type were classified as having submucosal cancer, while in those with 0-IIa type lesions (i.e., slightly elevated subtype of superficial and flat type lesions), the depth of invasion was m1-m3. All patients with 0-IIb type lesions (i.e., flat subtype of superficial and flat type lesions) were classified as having m1 cancer. In patients with 0-IIc type lesions (i.e., slightly depressed subtype of superficial and flat type lesions), it was difficult to diagnose the depth of invasion, because there was a wide distribution from m1 to sm3. Endoscopic diagnostic efficacy, with regards to the depth of cancer invasion, was evaluated. The depth of invasion was accurately diagnosed by endoscopy in 91% of the patients with m1-m2 cancer and in 83% of the patients with sm2-sm3 cancer. On the other hand, the accuracy rate in diagnosing the depth of invasion was only 37% in patients with m3-sm1 cancer. Our results suggest the necessity of total diagnosis employing not only conventional endoscopy but also endoscopic staining, roentogenography and endoscopic ultrasonography etc. |
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