INTESTINE Vol.10 No.3(2-1)

特集名	拡大内視鏡による質的診断の進歩 -- V_I型pitから血管構造・Endo-Cystoscopy・IBDまで
題名	V_I型pit patternにおける不整の程度と浸潤度 (1) 内視鏡治療の立場から
発刊年月	2006年 05月
著者	松田尚久	国立がんセンター中央病院内視鏡部
著者	斎藤豊	国立がんセンター中央病院内視鏡部
著者	浦岡俊夫	国立がんセンター中央病院内視鏡部
著者	池原久朝	国立がんセンター中央病院内視鏡部
著者	真下由美	国立がんセンター中央病院内視鏡部
著者	菊地剛	国立がんセンター中央病院内視鏡部
著者	岡部尚子	国立がんセンター中央病院内視鏡部
著者	滝沢耕平	国立がんセンター中央病院内視鏡部
著者	立石陽子	国立がんセンター中央病院内視鏡部
著者	斉藤大三	国立がんセンター中央病院内視鏡部
著者	佐野寧	国立がんセンター東病院内視鏡部消化器科
著者	藤井隆広	藤井隆広クリニック
【要旨】	要旨はありません。

Theme	Development of diagnosis of magnifying endoscopy
Title	Efficacy of magnifying colonoscopy in diagnosing the depth of invasion of colorectal cancer
Author	Takahisa Matsuda	Division of Endoscopy, National Cancer Center Hospital
Author	Yutaka Saito	Division of Endoscopy, National Cancer Center Hospital
Author	Toshio Uraoka	Division of Endoscopy, National Cancer Center Hospital
Author	Hisatomo Ikehara	Division of Endoscopy, National Cancer Center Hospital
Author	Yumi Mashimo	Division of Endoscopy, National Cancer Center Hospital
Author	Tsuyoshi Kikuchi	Division of Endoscopy, National Cancer Center Hospital
Author	Naoko Okabe	Division of Endoscopy, National Cancer Center Hospital
Author	Kohei Takizawa	Division of Endoscopy, National Cancer Center Hospital
Author	Yoko Tateishi	Division of Endoscopy, National Cancer Center Hospital
Author	Daizo Saito	Division of Endoscopy, National Cancer Center Hospital
Author	Yasushi Sano	Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East
Author	Takahiro Fujii	Takahiro Fujii Clinic
[ Summary ]	It has been said that is possible to estimate the depth of invasion of neoplastic colorectal lesions using magnifying colonoscopy in order to decide the correct treatment. Magnifying colonoscopy identifies a typical pattern, termed “invasive pattern”, which consists of irregular, distorted colonic gland crypts in a demarcated area. This type of pattern corresponds to submucosal deep (sm_{2 - 3}) invasive cancer. It especially corresponds with completely destroyed muscularis mocosae. The calculated sensitivity, specificity, and accuracy were 85.6 %, 99.4 %, and 98.8 % respectively to differentiated intramucosal or sm₁ invasion (<1,000 μm) from sm_{2 - 3} invasion (≥1,000 μm). Of the lesions which were endoscopically diagnosed as “invasive pattern”, a high percentage had invasive cancer, especially sm_{2 - 3} invasive cancer, where surgical resection is undoubtedly the proper treatment.

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