| 特集名 | 早期消化管癌に対するEMR -- 適応拡大をめぐる問題 | |
|---|---|---|
| 題名 | 早期胃癌に対するEMR (2) EUSによる深達度の評価 | |
| 発刊年月 | 2001年 11月 | |
| 著者 | 三島 利之 | JR仙台病院消化器内視鏡センター |
| 著者 | 長南 明道 | JR仙台病院消化器内視鏡センター |
| 著者 | 安藤 正夫 | JR仙台病院消化器内視鏡センター |
| 著者 | 田村 知之 | JR仙台病院消化器内視鏡センター |
| 著者 | 日下 利広 | 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 】 | 当センターで定めたEMRの適応病巣の深達度診断におけるEUSの役割について，内視鏡診断と比較し検討した．過去5年間に当センターで切除された早期胃癌のうちEUS，内視鏡の両者が施行され，深達度を除きEMRの適応条件を満たす182病巣を対象に，EUSおよび内視鏡の深達度診断能を，肉眼型別，部位別に比較検討し，さらにEUS診断能と内視鏡診断能を対比した．その結果，肉眼型別，部位別でEUSおよび内視鏡の深達度診断能に差はなく，両者の診断能を対比しても差はみられなかった．すなわち，EMRの適応決定において，EUSは必須の検査とは言えないと考えられた． | |
| Theme | Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer | |
|---|---|---|
| Title | Evaluation of the Depth of Invasion of Early Gastric Cancers by Endoscopic Ultrasonography for Endoscopic Mucosal Resection | |
| Author | Toshiyuki Mishima | Digestive Endoscopy Center, JR Sendai Hospital |
| Author | Akimichi Chonan | Digestive Endoscopy Center, JR Sendai Hospital |
| Author | Masao Ando | Digestive Endoscopy Center, JR Sendai Hospital |
| Author | Tomoyuki Tamura | Digestive Endoscopy Center, JR Sendai Hospital |
| Author | Toshihiro Kusaka | Digestive Endoscopy Center, JR Sendai Hospital |
| Author | Fukuji Mochizuki | Digestive Endoscopy Center, JR Sendai Hospital |
| [ Summary ] | We evaluated the depth of invasion of early gastric cancers, using endoscopic ultrasonography (EUS) for endoscopic mucosal resection (EMR), and compared the diagnostic ability of EUS with that of endoscopy in 182 lesions. The lesions corresponded to the indication of EMR in size, macroscopic type, microscopic type, and depth of ulceration. Because of difficulties evaluating the depth of invasion in lesions under 1mm, we devided the lesions into two categories; i.e. M-SM1 and SM2. The depth of invasion of M-SM1 cancers was less than 1mm, and that of SM2 cancers was over 1mm. In regard to macroscopic type or site of the lesions, the accuracy rate of EUS was high, but it was not significantly different from that found with endoscopy. The number of lesions was 166 (91.2%) using EUS, and endoscopy, to correctly diagnose the depth of invasion. We encountered five lesions (2.7%) of early gastric cancers which were correctly diagnosed with EUS, but were inaccurately diagnosed with endoscopy. On the other hand, we encountered four lesions (2.2%) which were correctly diagnosed with endoscopy, but inaccurately diagnosed with EUS. In conclusion, it can be said that we can eliminate EUS exams when evaluating of the depth of invasion of early gastric cancers with correspond to the indication for EMR. |
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