| 特集名 | 消化器癌の予防医学 | |
|---|---|---|
| 題名 | 胃癌二次予防の現況と展望 | |
| 発刊年月 | 2006年 06月 | |
| 著者 | 奥田 順一 | 朝日大学村上記念病院消化器内科 |
| 著者 | 井田 和徳 | 朝日大学村上記念病院消化器内科 |
| 著者 | 坂井 宏美 | 朝日大学村上記念病院消化器内科 |
| 著者 | 横溝 千尋 | 朝日大学村上記念病院消化器内科 |
| 著者 | 小島 孝雄 | 朝日大学村上記念病院消化器内科 |
| 著者 | 加藤 隆弘 | 朝日大学村上記念病院消化器内科 |
| 【 要旨 】 | 胃集団検診 (胃集検) の平成15年度の受診者総数は5,975,956人，要精検率は9.82 ％，胃癌発見率は0.099 ％である．大きさ別では，1 cm以下が15.9 ％，1.1 - 2.0 cmが25.2 ％，2.1 - 3.0 ｃｍが18.8 ％，3.1 cm以上が40.1 ％である．M癌42.3 ％，SM癌27.3 ％と早期胃癌が69.5 ％を占め，そのうちIIc型が54.4 ％である．粘膜像の描出能向上を目的として新・胃X線撮影法が作成され，その特徴は131 - 150 ml の少量で高濃度・低粘度造影剤 (200 - 220 W / V %) を用い，二重造影を中心に撮影法が組み合わされている．近年，効率的かつ内視鏡治療可能な癌の検診を目指して，ペプシノゲン法，H. pylori感染との併用，さらには内視鏡検診，受診者の個別化 (癌危険群) の検討も進んでいる． | |
| Theme | Preventive Medicine of Gastrointestinal Cancer | |
|---|---|---|
| Title | Secondary Prevention of Gastric Cancer : Present and Future | |
| Author | Junichi Okuda | Department of Internal Medicine, Murakami Memorial Hospital, Asahi University |
| Author | Kazunori Ida | Department of Internal Medicine, Murakami Memorial Hospital, Asahi University |
| Author | Hiromi Sakai | Department of Internal Medicine, Murakami Memorial Hospital, Asahi University |
| Author | Chihiro Yokomizo | Department of Internal Medicine, Murakami Memorial Hospital, Asahi University |
| Author | Takao Kojima | Department of Internal Medicine, Murakami Memorial Hospital, Asahi University |
| Author | Takahiro Kato | Department of Internal Medicine, Murakami Memorial Hospital, Asahi University |
| [ Summary ] | The number of people who underwent mass screening for gastric cancer in 2003 was 5,975,956. Gastric cancer was discovered in 5,970 people, with a detection rate of 0.099 %. The breakdown of gastric cancer sizes was as follows : ≤1 cm, 15.9 % ; 1.1 - 2.0 cm, 25.2 % ; 2.1 - 3.0 cm, 18.8 % ; and ≤3.1 cm, 40.1 %. Invasion depths for gastric cancer were as follows : M 42.3 % ; and SM 27.3 %. Early cancer thus accounted for 69.5 % of the total, and 54.4 % of Type 0 were IIc. A new X-ray technique has been developed to improve gastric mucosa visualization and early gastric cancer detection as well as to lower the percentage of people requiring additional tests. With this new technique, a small amount (131 - 150 ml) of highly-concentrated, low-viscosity contarast media (200 - 220 W / V %) is used. Different imaging techiniques, primarily double-contrast radiography, are combined with the above mentioned modalities. In recent years, to efficiently diagnose gastric cancer, identify early gastric cancer and establish cancer screening in which endoscopic therapy is possible, studies have been conducted to combine pepsinogen and Helicobacter pylori tests. Furthermore, studies have been conducted to review endoscopic screening and identify individuals at high risk of cancer. |
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