INTESTINE Vol.22 No.2(12)


連載名 第26回大腸IIc研究会優秀演題
題名 大腸Interval cancerの責任病変は?
発刊年月 2018年 02月
著者 藤井 隆広 藤井隆広クリニック
【 要旨 】 interval cancer (post-colonoscopy colorectal cancer ; PCCRC)は中間期癌と呼ばれ,一定の間隔でがん検診を実施しているとき,その検診間隔の間に発見される癌のことをいう.PCCRCには,見逃し癌と急速発育癌の二つの要因が絡むとされ,見逃し癌がほとんどとする報告が多く,海外からは,その責任病変として右半結腸の大腸鋸歯状病変(sessile serrated lesion ; SSL)が有力とされている.当院で発見された8例のPCCRCも見逃しがおもな要因と考えるが,それらにはSSL関連性病変はなく,深達度T2の進行癌2例は陥凹型由来,その他の6例はLST-NGとIIa+IIc型早期癌であった.PCCRCの責任病変としては,SSLよりも平坦・陥凹型病変が重要と考えられた.
Series 26th Annual Meeting on Depressed Colorectal Cancer
Title Cause of interval cancer lesions post complete colonoscopy
Author Takahiro Fujii TF Clinic
[ Summary ] In recent years, interval cancer (IC) or post-colonoscopy colorectal cancer (PCCRC) has become a focus of attention as likely representing "missed" or "rapidly-growing" lesions in relation to colonoscopic screening for colorectal cancer (CRC). It is currently assumed in Western countries that sessile serrated lesions (SSL) may be the likely culprits responsible for PCCRC in many cases. Eight cases were determined to be related to PCCRC, detected during colonoscopy. They were observed in the TF clinic, and exhibited typical macroscopic aspects of PCCRC in cases where all lesions were flat and depressed. Flat-depressed lesions may be likely culprits for PCCRC as observed in this study.
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