| 特集名 | 新しい内視鏡観察法の分類 -- 画像強調観察を中心に | |
|---|---|---|
| 題名 | 顕微内視鏡観察 (Endoscopic Microscopy) (1) Endo-cytoscopy | |
| 発刊年月 | 2009年 01月 | |
| 著者 | 熊谷 洋一 | 太田西の内病院外科 |
| 著者 | 川田 研郎 | 東京医科歯科大学食道胃外科 |
| 著者 | 山崎 繁 | 太田西の内病院外科 |
| 著者 | 東海林 裕 | 太田西の内病院外科 |
| 著者 | 飯田 道夫 | 太田西の内病院外科 |
| 著者 | 河野 辰幸 | 東京医科歯科大学食道胃外科 |
| 【 要旨 】 | 近年の内視鏡技術の進歩はpit pattern診断，微細血管診断など詳細な情報を得ることが可能になり，癌の早期発見に寄与している．早期に発見された癌は内視鏡的粘膜切除など縮小治療の恩恵を受けることが可能で，より早期に発見することが期待される． 一方，現行の拡大内視鏡を超えた超拡大観察による"仮想生検 (virtual histology)"が提唱され，生体内での細胞の観察が注目されるようになった．これを実現するため，生体内で最大1,100倍の拡大観察が可能な光学顕微鏡であるEndo-cytoscopy systemが開発された．このEndo-cytoscopeは生体染色することで細胞核を観察することができるため，生検組織診断に匹敵する情報を得ることができる． 本稿ではこのEndo-cytoscopy systemの詳細と文献的検索より長所，短所を紹介する． |
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| Theme | Consensus Terminology in Endoscopic Imaging -- Focusing on Image-enhanced Endoscopy | |
|---|---|---|
| Title | Endo-cytoscopy System | |
| Author | Youichi Kumagai | Department of Surgery, Ohta Nishinouchi Hospital |
| Author | Kenrou Kawada | Department of Surgery, Tokyo Medical and Dental University |
| Author | Shigeru Yamazaki | Department of Surgery, Ohta Nishinouchi Hospital |
| Author | Yutaka Tohkairin | Department of Surgery, Ohta Nishinouchi Hospital |
| Author | Michio Iida | Department of Surgery, Ohta Nishinouchi Hospital |
| Author | Tatsuyuki Kawano | Department of Surgery, Tokyo Medical and Dental University |
| [ Summary ] | Recent advances of the technology enable us to observe more detailed information during endoscopic procedure. Diagnosis of the pit pattern or micro-vascular architecture allowed us the earlier detection of the neoplastic lesion in the gastrointestinal tract. These advances have led to the enhanced selection of appropriate treatments. Cancers that are discovered at an early stage can be treated with mucosal resection, whereas advanced cancers are treated with surgery. Recently, some groups have tried to acquire a direct image of histology in vivo gastrointestinal mucosa (virtual histology or optical biopsy). To realize this conception, we developed the Endo-cytoscopy system that allows us up to 1,100 times magnifying observation in vivo. This instrument is "optical microscope" that can be inserted in the digestive tract. For magnified observation, vital staining, such as methylene blue or toluidine blue, is necessary to visualize the cells. Some investigators have been able to use this Endo-cytoscope to enhance cancer detection, and reported the usefulness of this technique. This article is aimed to introduce the detail of this Endo-cytoscopy system and to assess the strengths and weaknesses of this technology with reference to the previously published articles. |
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