| 特集名 | IBD関連大腸腫瘍の診断・治療update | |
|---|---|---|
| 題名 | 潰瘍性大腸炎関連大腸腫瘍の病理診断update | |
| 発刊年月 | 2018年 01月 | |
| 著者 | 田邉 寛 | 福岡大学筑紫病院病理部 |
| 著者 | 岩下 明德 | 福岡大学筑紫病院病理部 |
| 【 要旨 】 | 近年，本邦における潰瘍性大腸炎（UC）罹患者数の増加に伴いUC関連大腸癌患者数も増加傾向である．典型的なUC関連大腸癌は比較的若年者で多発例が多い．そして背景にdysplasiaを伴い，胃腸混合型の粘液形質を有する非常に分化の良い超高分化腺癌がおもに浸潤性に発育し，特異な肉眼型を呈することが多い．また，酸化ストレスの指標である8-OHdGが陽性となることがある．一方，UCにも一般的に発生する散発性癌（sporadic colorectal cancer）を合併することもある．それらの発症年齢は一般的な大腸癌と同様で60歳以上に多く，確かに病変周囲にUCの高度炎症がみられるが，単発で腸型の粘液形質を有する分化型癌がおもに膨張性に発育し，肉眼型は2型を呈することが多い．また8-OHdGは通常陰性である．生物学的態度や予後が異なる両者を鑑別することは重要と考えられる． | |
| Theme | Recent advance in diagnosis and management of colorectal tumors associated with inflammatory bowel disease | |
|---|---|---|
| Title | Update on the pathological diagnosis of ulcerative colitis-associated colorectal neoplasm | |
| Author | Hiroshi Tanabe | Department of Pathology, Fukuoka University Chikushi Hospital |
| Author | Akinori Iwashita | Department of Pathology, Fukuoka University Chikushi Hospital |
| [ Summary ] | Recently, the number of patients with ulcerative colitis-associated colorectal cancer (UC-CRC) is increasing in Japan. The clinicopathological characteristics of UC-CRC are as follows : relatively occurs in young patients who have multiple lesions, is accompanied by dysplasia, the histological type of the many lesions is very well-differentiated adenocarcinoma with mixed gastric and intestinal mucin phenotype, the carcinoma sporadically infiltrates into the colorectal wall, and the macroscopic type of most lesions is unusual. Immunohistochemically, both carcinomatous cells and non-carcinomatous cells in background mucosa of UC are sometimes positive for 8-OHdG, which is a marker of oxidative damage. Sporadic colorectal cancer (SP-CRC) in patients with UC usually occurs in patients over 60 years of age. An SP-CRC lesion is single, and the macroscopic type of almost all lesions is ulcerative-expansive type. In addition, almost all SP-CRC lesions are immunohistochemically negative for 8-OHdG. There are biological differences between UC-CRC and SPCRC, and it is vital to distinguish them. |
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