| 特集名 | Barrett食道 | |
|---|---|---|
| 題名 | Barrett食道癌の予後 | |
| 発刊年月 | 2007年 01月 | |
| 著者 | 西 隆之 | 東海大学医学部消化器外科 |
| 著者 | 幕内 博康 | 東海大学医学部消化器外科 |
| 著者 | 島田 英雄 | 東海大学医学部消化器外科 |
| 著者 | 千野 修 | 東海大学医学部消化器外科 |
| 著者 | 山本 壮一郎 | 東海大学医学部消化器外科 |
| 著者 | 原 正 | 東海大学医学部消化器外科 |
| 著者 | 葉梨 智子 | 東海大学医学部消化器外科 |
| 【 要旨 】 | 2006年7月までのBarrett食道癌本邦報告例は465症例で，近年，増加傾向にある．そのうち5年以上生存した症例は，SMまでの表在癌で，ly (-)，v (-)，n (-)が多く，原病死した症例は，MP以深の進行癌で，ly (+)，v (+)，n (+) が多かった．当科で扱ったBarrett食道癌は31例中，表在癌20例の原病死は1例のみと予後良好であるが，MP以深の進行癌は11例中4例が原病死しており，予後不良である． Barrett食道癌は，表在癌のうちはほとんどが高分化型腺癌で，リンパ節転移もさほど多くはないが，MP以深では低分化，未分化といった悪性度の高い組織型が出現し，リンパ節転移も高率に陽性となることが，予後不良の原因と考えられる．M癌には内視鏡的治療，SM以深癌にはリンパ節郭清を伴った手術が必要である． |
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| Theme | Barrett's Esophagus | |
|---|---|---|
| Title | Prognosis of Barrett's Cancer | |
| Author | Takayuki Nishi | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Hiroyasu Makuuchi | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Hideo Shimada | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Osamu Chino | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Soichiro Yamamoto | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Tadashi Hara | Department of Digestive Surgery, Tokai University, School of Medicine |
| Author | Tomoko Hanashi | Department of Digestive Surgery, Tokai University, School of Medicine |
| [ Summary ] | 465 cases of Barrett's cancer were reported from 1973 to 2006 in Japan. Most patients that survived more than 5 years were those with superficial cancers without lymph node metastasis. Most terminal cases of Barrett's cancer were those with advanced cancer and lymph node metastasis. We experienced 31 cases of Barrett's cancer. Out of 20 superficial cancer cases, only one patient died due to cancer, whereas 4 out of 11 advanced cancer patients died. Most superficial Barrett's cancers are well differentiated adenocarcinoma and have little lymph node metastasis. However, advanced cases display poorly or undifferentiated adenocarcinoma with a great deal of lymph node metastasis. Concerning treatment strategies for Barrett's cancer, endoscopic procedures are indicated for mucosal cancer and surgical procedures with lymph node dissection are required for deeper invasion into the submucosal layer. |
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