| 特集名 | 大腸LST（側方発育型腫瘍）の新展開 | |
|---|---|---|
| 題名 | LSTの通常内視鏡診断―非拡大色素撒布も含めて | |
| 発刊年月 | 2015年 08月 | |
| 著者 | 前山 泰彦 | 久留米大学医学部内科学講座消化器内科部門／消化器病センター |
| 著者 | 鶴田 修 | 久留米大学医学部内科学講座消化器内科部門／消化器病センター |
| 著者 | 野田 哲裕 | 久留米大学医学部内科学講座消化器内科部門／消化器病センター |
| 著者 | 長田 修一郎 | 久留米大学医学部内科学講座消化器内科部門／消化器病センター |
| 著者 | 河野 弘志 | 聖マリア病院消化器内科 |
| 【 要旨 】 | 通常観察でのLSTの質診断は，他の肉眼形態の大腸腫瘍と同様，腺腫と癌の鑑別には陥凹の存在，二段隆起，色調の不均一などの所見が役立つと考えられる．当施設の過去の検討では，LST‒Gは腫瘍径が大きくなるに従い担癌率が上昇し，LST‒NGは小さい病変においても担癌率が高く，深部浸潤率も高値であった．とくに結節混在型と偽陥凹型は担癌率が高いという特徴があった． 深達度診断においては緊満感を伴う二段隆起または陥凹内隆起が重要であった． LSTは亜分類によって多少性格が異なり，内視鏡的診断を行うためには，まず形態的特徴を把握したうえで診断を展開する必要性があると思われる． |
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| Theme | New Development of Laterally Spreading Tumor | |
|---|---|---|
| Title | Endoscopic Diagnosis of Laterally Spreading Tumors | |
| Author | Yasuhiko Maeyama | Division of Gastroenterology, Department of Medicine / Department of Endoscopy, Center for Gastroenterology, Kurume University School of Medicine |
| Author | Osamu Tsuruta | Division of Gastroenterology, Department of Medicine / Department of Endoscopy, Center for Gastroenterology, Kurume University School of Medicine |
| Author | Tetsuhiro Noda | Division of Gastroenterology, Department of Medicine / Department of Endoscopy, Center for Gastroenterology, Kurume University School of Medicine |
| Author | Shuichiro Nagata | Division of Gastroenterology, Department of Medicine / Department of Endoscopy, Center for Gastroenterology, Kurume University School of Medicine |
| Author | Hiroshi Kawano | Department of Gastroenterology, St. Mary's Hospital |
| [ Summary ] | For the differential diagnosis of adenoma or carcinoma with laterally spreading tumor (LST), observation of the presence of depressions, nodule on nodule, and heterogeneity of color is useful. We previously reported that the larger lesions are associated with early cancer and are more common in patients with granular type (LST‒G). On the other hand, non‒granular type (LST‒NG) are associated with smaller lesions than LST‒G, yet the rates of invasive cancer were higher than those observed with LST‒G. Investigation of macroscopic findings of invasive cancer revealed lesions exhibiting elevation with swelling. This is a very important sign for diagnosis of invasive cancer. |
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