| 特集名 | 食道・胃の前癌病変，高発癌状態をめぐって | |
|---|---|---|
| 題名 | 食道扁平上皮癌の危険因子および前癌病変 | |
| 発刊年月 | 2010年 03月 | |
| 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 | 名久井 実 | 東海大学医学部消化器外科 |
| 著者 | 小澤 壮治 | 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 |
| 【 要旨 】 | 食道扁平上皮癌は多段階発癌(multistep carcinogenesis)し，dysplasia は前癌病変(precancerous lesion)として取り扱われてきた．しかし，dysplasiaの程度やcarcinoma in situとの鑑別に関しては，欧米や本邦での病理医において見解の相違があった． 今日では，dysplasiaはintraepithelial neoplasiaとしてlow gradeとhigh gradeに分類されている．臨床的には，high grade intraepithelial neoplasiaと診断された病巣に対する処置が問題となる． また，食道扁平上皮癌ではハイリスク群として，長年にわたる多量飲酒，喫煙者，男性，頭頸部癌症例，食道アカラシア，腐食性食道炎(corrosive esophagitis)などが知られている．臨床面では，これらハイリスク群に対する内視鏡検査による食道スクリーニングが必要である． |
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| Theme | Precancerous Conditions and Cancer High-risk Lesions in the Esophagus and the Stomach | |
|---|---|---|
| Title | Risk Factors and Precancerous Lesions Associated with Esophageal Squamous Cell Carcinoma | |
| Author | Hideo Shimada | Department of Surgery, Tokai University School of medicine |
| Author | Osamu Chino | Department of Surgery, Tokai University School of medicine |
| Author | Soichiro Yamamoto | Department of Surgery, Tokai University School of medicine |
| Author | Minoru Nakui | Department of Surgery, Tokai University School of medicine |
| Author | Soji Ozawa | Department of Surgery, Tokai University School of medicine |
| Author | Hiroyasu Makuuchi | Department of Surgery, Tokai University School of medicine |
| [ Summary ] | Dysplasia is considered to be a type of precancerous lesion associated with the multistepcarcinogenesis of esophageal squamous cell carcinoma. However, there is disagreement among pathologists in the United States, Europe, and Japan concerning the degree of dysplasia and the difference between dysplasia and carcinoma in situ. Today, dysplasia is categorized into the categories of lowgrade and high-grade intraepithelial neoplasia. Treatment for lesions diagnosed as high-grade intraepithelial neoplasia presents a clinical problem. Furthermore, the high-risk groupfor esophageal squamous cell carcinoma includes those with long histories of heavy alcohol intake, cigarette smoking, males, and patients with a history of head or neck cancer, esophageal achalasia, or corrosive esophagitis. In clinical settings, endoscopic screening of the esophagus is warranted for these high-risk patients. |
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