臨牀消化器内科 Vol.14 No.8(4-3)


特集名 レーザー内視鏡の理論と実際 --21世紀消化器内視鏡学への提言
題名 不可視情報の画像化 --新しい内視鏡診断学の展望 (3) 消化管癌の蛍光内視鏡診断
発刊年月 1999年 07月
著者 荻原 達雄 順天堂大学医学部消化器内科
【 要旨 】 青色励起光により腫瘍組織では正常組織に比べ赤色偏移した特異的自家蛍光が励起されることを利用し,腫瘍性病変を早期に検出する内視鏡的自家蛍光観察装置が試作され臨床的有用性について検討を行っている.本装置では通常ファイバースコープを用いて自家蛍光を2波長の高感度CCDで検出し画像処理後モニター表示される.消化管粘膜では青色調を示す背景粘膜に対し腫瘍部は暗赤~赤褐色で示され,肉眼では認識困難な微小腫瘍性病変の早期検出や病変範囲の同定等が容易となる.本装置の改良が進めば蛍光増感物質の投与を行わないスクリーニング検査に用いることができ,組織学的診断のための生検を必要としない非侵襲的腫瘍性病変検出の可能性も期待できる.
Theme Laser Endoscopy in Theory and Practice --Perspective of GI Endoscopy in the 21st Century
Title Diagnosis of Gastrointestinal Neoplastic Tissue Using an Autofluorescence Endoscopy
Author Tatsuo Ogihara Department of Gastroenterology, Juntendo University School of Medicine
[ Summary ] Autofluorescence spectra of neoplastic tissues have been reported to be significantly different from those of normal tissues when excited by blue or violet light. Laser induced autofluorescence endoscopic imaging system (LIFE Lung, by Xillix , in Canada and Olympus, in Japan) was developed for the detection of early cancerous or pre-cancerous lesions in the lung. Based on the LIFE-Lung system, a prototype of light-induced autofluorescence endoscopic imaging system for gastrointestinal mucosa (LIFE-GI) has recently been developed and the clinical usefulness of the prototype system has been demonstrated in several hospitals. The system consists of a blue light source for excitation, a white light source for conventional observation, a fiber optical endoscope, two intensified CCD cameras (green and red) for the detection of weak autofluorescence image and a monitor, on which a pseudo color image of neoplastic lesion is displayed, in real time. This system was applied to the early detection of remnant lesions after endoscopic treatment of early gastric cancer and to the detection of laterally spreading superficial colonic tumors. The results suggested these lesions could be detected with this system. This system, which needs no administration of a photosensitive agent, has potential application for the diagnosis of dysplastic land cancerous lesions in the gastrointestinal tract, and may be suitable as a screening method for the early detection of neoplastic tissues.
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