臨牀消化器内科 Vol.29 No.6(5-3)


特集名 Barrett食道の診断と治療up-to-date
題名 Barrett食道の内視鏡診断 (3) Barrett食道・腺癌の国際内視鏡分類―プラハ分類・拡大内視鏡分類
発刊年月 2014年 06月
著者 郷田 憲一 東京慈恵会医科大学内視鏡科
著者 田尻 久雄 東京慈恵会医科大学消化器・肝臓内科
【 要旨 】 欧米諸国と同様に,本邦でもBarrett腺癌の増加が危惧されている.
Barrett食道・腺癌に対する内視鏡診断学は,本邦に比し圧倒的に有病率が高い欧米において,いち早く系統化され,さまざまな国際的分類が作成された.その過程において,本邦独自の内視鏡診断学との間に差異が生じてしまった.将来的に本邦独自の理想的な内視鏡診断体系を構築するうえで,これまでに提唱された国際分類に対する理解を深める必要があろう.
そこで,本稿では欧米を中心に国際的に広く認知されているBarrett食道・腺癌に関する内視鏡分類について概説するとともに,それらの問題点と今後の課題にまで言及したい.
Theme Diagnosis and Treatment of Barrett's Esophagus : up-to-date
Title International Endoscopy Classification of Barrett'ʼs Esophagus and Esophageal Adenocarcinoma
Author Kenichi Goda Department of Endoscopy, The Jikei University School of Medicine
Author Hisao Tajiri Department of Gastroenterology and Hepatology, The Jikei University School of Medicine,
[ Summary ] Concerns have been raised about the increase in incidence rates for Barrett's adenocarcinoma in Japan as if following Western countries. Several diagnostic systems and classifications were established in Western countries ahead of our country. Unfortunately, those systems and classifications are based on diagnostic methods which are different than those used in Japan. Japanese endoscopists must improve their knowledge of Western systems in order to improve their diagnostic abilities to detect dysplasia or early cancer arising from Barrett's esophagus. Steps must also be taken to develop an ideal diagnostic system for Japanese patients with this disease. Well-known Western diagnostic systems and problems with those systems are discussed.
戻る