| 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 | 早期大腸癌に対するEMR (2) 早期大腸癌に対する内視鏡的摘除術適応決定における内視鏡的超音波断層法の有用性 | |
| 発刊年月 | 2001年 11月 | |
| 著者 | 掛村 忠義 | 東邦大学医学部第三内科 |
| 著者 | 石塚 俊一郎 | 東邦大学医学部第三内科 |
| 著者 | 吉田 光宏 | 東邦大学医学部第三内科 |
| 著者 | 吉本 一哉 | 東邦大学医学部第三内科 |
| 著者 | 藤沼 澄夫 | 東邦大学医学部大橋病院消化器診断部 |
| 著者 | 酒井 義浩 | 東邦大学医学部大橋病院消化器診断部 |
| 【 要旨 】 | EUSは消化管癌の深達度診断の客観的指標として重要性を増している．大腸領域では専用機と超音波プローブを用いるが，有益な情報を得るためには機器の特性を考慮してEUSを施行すべきである．表面構築像と断層像を用いた3D表示により病変の立体的な理解が深まり，病変最深部の評価において3D-EUSの有用性は高いと考える．早期大腸癌の内視鏡的摘除術の適応決定においては，組織学的sm浸潤度判定基準の問題もあるが，現状ではEUS独自の特性をふまえた解析が必要で，絶対値を意識した判定を模索しているのが現状である．多施設間での調整のもとに検討を進め，EUSの役割がより明確にされることが期待される． | |
| Theme | Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer | |
|---|---|---|
| Title | Usefulness of Endoscopic Ultrasonography (EUS) in Determining the Indication of Endoscopic Resection for Early Colorectal Cancers | |
| Author | Tadayoshi Kakemura | 3rd Department of Internal Medicine, Toho University School of Medicine |
| Author | Shunichiro Ishitsuka | 3rd Department of Internal Medicine, Toho University School of Medicine |
| Author | Mitsuhiro Yoshida | 3rd Department of Internal Medicine, Toho University School of Medicine |
| Author | Kazuya Yoshimoto | 3rd Department of Internal Medicine, Toho University School of Medicine |
| Author | Sumio Fujinuma | Division of Digestive Endoscopy, Ohashi Hospital, Toho University School of Medicine |
| Author | Yoshihiro Sakai | Division of Digestive Endoscopy, Ohashi Hospital, Toho University School of Medicine |
| [ Summary ] | Endoscopic ultrasonography (EUS) has been important as an objective method in the diagnosis of depth invasion of digestive tract cancers. Echocolonoscopes and ultrasonic probes are used in EUS for colorectal diseases. EUS should be performed to provide valuable information in the consideration of performance characteristics. 3D manifestation, composed of surface rendered images and cross section images, enables us to understand the structure of lesions spatially. 3D-EUS should be useful to explore the deepest point of cancer invasion. The ultrasonic layer structure of the colon wall was demonstrated in ultrasonic images, consisting of 11 layers, at the maximum. However, in clinical cases, the colonic wall structure was usually divided into 9 layers. The images which corresponded to the muscularis mucosae cloud could not be continuously visualized. In determining the indication for endoscopic resection for early colorectal cancers, there are many problems with histological classification for the assessment of the depth of submucosal cancer invasion. Under the present circumstances, assessments peculiar to EUS, which enable us to be aware of histological classifications according to the vertical length of submucosal cancer invasion, are necessary. Further investigation into EUS in the diagnosis of early colorectal cancer invasion will provide increasingly superior information for endoscopic resection. |
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