| 特集名 | 大腸癌のスクリーニング検査の現状 | |
|---|---|---|
| 題名 | 画像診断によるスクリーニング検査の現状 (4) NBIを用いたスクリーニング法の現状と展望 | |
| 発刊年月 | 2008年 02月 | |
| 著者 | 豊田 昌徳 | 佐野病院消化器センター |
| 著者 | 小高 雅人 | 佐野病院消化器センター |
| 著者 | 山口 まゆみ | 佐野病院消化器センター |
| 著者 | 辻 あさか | 佐野病院消化器センター |
| 著者 | 佐野 寧 | 佐野病院消化器センター／国立がんセンター東病院消化器内科内視鏡部 |
| 【 要旨 】 | 1999年よりわれわれが開発してきた，内視鏡観察光の分光特性を狭帯域特性へ変更 (短波長側にシフト) することで，病変の視認性や表面微細構造，毛細血管観察の向上を可能にしたNarrow Band Imaging (NBI) systemの大腸内視鏡検査における有用性について述べた． NBIを大腸内視鏡検査に導入することで，腫瘍・非腫瘍の鑑別はmeshed capillary (MC) -like vesselの存在で可能となり，色素観察が不要となる．また，毛細血管構築を中心としたcapillary pattern (CP) の観察により，質的・量的診断が瞬時に可能となってきた． |
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| Theme | Current Status of Colorectal Cancer Screening | |
|---|---|---|
| Title | Screening Colonoscopy Using Narrow Band Imaging (NBI) System | |
| Author | Masanori Toyoda | Department of Gastrointestinal Center, Sano Hospital |
| Author | Masahito Kotaka | Department of Gastrointestinal Center, Sano Hospital |
| Author | Mayumi Yamaguchi | Department of Gastrointestinal Center, Sano Hospital |
| Author | Asaka Tsuji | Department of Gastrointestinal Center, Sano Hospital |
| Author | Yasushi Sano | Department of Gastrointestinal Center, Sano Hospital / Department of GI Oncology & Endoscopy, National Cancer Center Hospital East |
| [ Summary ] | Narrow band imaging (NBI) systems are based on modifying spectral features by narrowing the bandwidth of spectral transmittance with optical filters. Since 1999, our team has been developing a proprietary NBI system. NBI modification provides unique images, emphasizing capillary pattern, and surface structures without dye solutions. NBI colonoscopy, focusing on magnifying observation of the microvascular architecture of colorectal lesions are reviewed. The utility of detailed observations of the microvascular architecture for differential diagnosis during NBI colonoscopy are also examined. Angiogenesis is critical for the transition of premalignant lesions to a hyperproliferative state to malignant phenotypes. Therefore, diagnosis based on angiogenic or vascular morphologic changes, may be ideal for early detection or diagnosis of neoplasms. In this review, the term “meshed capillary (MC) -like vessel” is proposed to make a distinction between non-neoplastic and neoplastic lesions, as well as the microvascular classification “capillary pattern CP”. This would be used for the differential diagnosis of colorectal lesions. It is believed that the combined use of NBI optical chromoendoscopy and real chromoendoscopy decreases the time and cost of screening colonoscopy. To assess the feasibility and efficacy of using NBI systems, further studies are required concerning colorectal lesions. |
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