| 特集名 | 拡大内視鏡の現況と問題点 | |
|---|---|---|
| 題名 | 食道扁平上皮癌の拡大内視鏡による診断 | |
| 発刊年月 | 2006年 04月 | |
| 著者 | 熊谷 洋一 | 太田西の内病院外科 |
| 著者 | 山崎 繁 | 太田西の内病院外科 |
| 著者 | 飯田 道夫 | 太田西の内病院外科 |
| 【 要旨 】 | 食道表在癌の早期発見は患者のQOLを向上させるために必要不可欠である．100倍の拡大能を有するQ240Z，450倍，1,125倍のEndo-Cytoscopy System (Olympus試作) を用い早期発見につながる所見を解説した． Q240Zでの観察は正常食道粘膜の上皮乳頭内ループ状毛細血管 (IPCL) に注目した．癌部ではIPCLは「拡張，蛇行，口径不同，形状不均一」の異常所見を呈していた．Endo-Cytoscopy Systemではメチレンブルーで生体染色が必要である．正常重層扁平上皮のN / C比が低く，核の染色性，大きさが同等なのに比べ，癌部では細胞密度の増加，核の染色性，大きさの不揃いな核異型が観察された． |
|
| Theme | Current Status of Magnifying Endoscopy | |
|---|---|---|
| Title | Diagnosis of Esophageal Squamous Cell Carcinoma | |
| Author | Youichi Kumagai | Department of Surgery, Ohta Nishinouchi Hospital |
| Author | Shigeru Yamazaki | Department of Surgery, Ohta Nishinouchi Hospital |
| Author | Michio Iida | Department of Surgery, Ohta Nishinouchi Hospital |
| [ Summary ] | Early detection of superficial esophageal cancer is indispensable in order to promote improvements in QOL for patients. This article comments on findings which led to early diagnosis of esophageal cancer with a Q240Z system having 100 power magnification, and an Endo-Cytoscopy System with 450 and 1125 power (Olympus). Observation with the Q240Z system observed the intra-papillary capillary loop (IPCL) of normal esophageal mucosa. IPCL presented abnormal findings of “dilation, weaving, changes of caliber and variety of shapes” in cancer. Vital staining is necessary with methylene blue in Endo-Cytoscopy Systems. By observing the normal esophageal mucosa with Endo-Cytoscopy Systems, using methylene blue staining, we were able to visualize those cells existent at the surface of the squamous epitherium. Those cells were arranged in a homogenous manner and the nucleus-cytoplasmic ratio was uniform and low. In the observation of the esophageal cancer, the density of cells increased greatly, compared to the normal squamous epithelium. Cell distribution was irregular with extreme heterogeneity of the cells with nuclei of different staining ratios, size and shape. The nucleus-cytoplasm ratio was very irregular. |
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