| 特集名 | 下部消化管の前癌病変，高発癌状態をめぐって | |
|---|---|---|
| 題名 | 大腸憩室症と大腸腫瘍 | |
| 発刊年月 | 2010年 09月 | |
| 著者 | 岡本 真 | JR東京総合病院消化器内科 |
| 著者 | 大前 知也 | JR東京総合病院消化器内科 |
| 著者 | 山地 裕 | 東京大学大学院医学系研究科消化器内科学 |
| 著者 | 吉田 晴彦 | 東京大学大学院医学系研究科消化器内科学 |
| 著者 | 小池 和彦 | 東京大学大学院医学系研究科消化器内科学 |
| 【 要旨 】 | 近年わが国では食生活の欧米化に伴い，大腸癌やポリープ(腺腫)が増加している．同様に大腸憩室症も増加している．共通の背景をもつ大腸腫瘍と憩室症の関連について検討した． 自験9,377例の検討では，大腸腫瘍全体と憩室症とは有意な関連を認めた（OR＝1.17，95％ CI 1.06～1.30）．しかし大腸腫瘍を癌と腺腫に分けた場合，腺腫とは有意な関連を認めたものの（進行腺腫：OR＝1.35，95％ CI 1.16～1.57），大腸癌とは関連がなかった（OR＝0.92，95％ CI 0.76～1.12）． 欧米を中心とした過去の報告では，結論がさまざまに異なり，大腸癌・腺腫と憩室症との関連を結論づけることは現時点では難しい．しかし，腺腫とは関連があり，大腸癌とは関連がないとする報告が多かった．今後の検討が必要と考えられた． |
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| Theme | Precancerous Conditions and Cancer High-risk Lesions in the Colorectum | |
|---|---|---|
| Title | Relationship between Colonic Diverticulosis and Colorectal Neoplasia | |
| Author | Makoto Okamoto | Department of Gastroenterology, JR Tokyo General Hospital |
| Author | Tomoya Ohmae | Department of Gastroenterology, JR Tokyo General Hospital |
| Author | Yutaka Yamaji | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Haruhiko Yoshida | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| Author | Kazuhiko Koike | Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo |
| [ Summary ] | Recently, colorectal cancer and adenoma have increased in Japan. Colonic diverticulosis has also been reported to be increasing. Western diets have been regarded to play a major role in the pathogenesis of both conditions. The purpose of this study is to investigate the relationship between colorectal neoplasia and diverticulosis. A total of 9,377 patients undergoing colonoscopy in our institute were analyzed. Colonic diverticulosis was a significant risk factor for neoplasia including both colorectal cancer and adenoma (OR=1.17, 95 % CI 1.06-1.30). According to histology, small and advanced adenoma were significantly related to diverticulosis (advanced adenoma: OR=1.35, 95 % CI 1.16-1.57). On the other hand, colorectal cancer did not exhibit a relationship to diverticulosis (OR=0.92, 95 % CI 0.76-1.12). In the previous studies, results were still conflicting about the causal relationship between colorectal neoplasia and diverticulosis. Several studies have reported that colorectal cancer was not related to diverticulosis. However, it is difficult to confirm the relationship between the two conditions, and further study is needed. |
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