| 特集名 | FIT陰性癌の特徴 | |
|---|---|---|
| 題名 | FIT陰性癌の症例 (2) FIT陰性であったpT1b癌要 | |
| 発刊年月 | 2019年 09月 | |
| 著者 | 草場 喜雄 | 久留米大学医学部内科学講座消化器内科部門／久留米大学医学部消化器病センター |
| 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／久留米大学医学部消化器病センター |
| 著者 | 永田 務 | 久留米大学医学部内科学講座消化器内科部門／久留米大学医学部消化器病センター |
| 著者 | 大内 彬弘 | 久留米大学医学部内科学講座消化器内科部門／久留米大学医学部消化器病センター |
| 著者 | 中根 智幸 | 久留米大学医学部内科学講座消化器内科部門／久留米大学医学部消化器病センター |
| 著者 | 福永 秀平 | 久留米大学医学部内科学講座消化器内科部門／久留米大学医学部消化器病センター |
| 著者 | 向笠 道太 | 久留米大学医学部内科学講座消化器内科部門／久留米大学医学部消化器病センター |
| 著者 | 光山 慶一 | 久留米大学医学部内科学講座消化器内科部門／久留米大学医学部消化器病センター |
| 著者 | 鳥村 拓司 | 久留米大学医学部内科学講座消化器内科部門／久留米大学医学部消化器病センター |
| 【 要旨 】 | 免疫便潜血検査（fecal immunochemical test；FIT）陰性の上部直腸，径15mmの0-Ⅱa＋Ⅱc，pT1b癌を経験した．FIT偽陰性の原因として，① 実際出血していない，② 右側大腸癌は便に血液が均等に混じりやすいのに対し，直腸・S状結腸癌は部分的にしか血液が付着しないため，摂取部位により偽陰性になりやすいこと，などが考えられた．出血しない大腸癌の存在や，FIT検査はあくまで採便による簡潔な検査法であることを認識すべきであり，今回の症例は腹満感という症状や大腸癌の家族歴があり，そのような有病リスクのある患者に対してはFIT陰性であっても内視鏡検診を含めた更なる精密検査の必要性が示唆された． | |
| Theme | Clinical characteristics of fecal immunochemical test (FIT) negative colorectal cancer | |
|---|---|---|
| Title | Characteristics of colorectal cancers with negative fecal immunochemical test (FIT) | |
| Author | Yoshio Kusaba | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| Author | Osamu Tsuruta | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| Author | Tsutomu Nagata | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| Author | Akihiro Ouchi | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| Author | Tomoyuki Nakane | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| Author | Syuuhei Fukunaga | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| Author | Michita Mukasa | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| Author | Keiichi Mitsuyama | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| Author | Takuji Torimura | Division of Gastroenterology, Division of GI Endoscopy, Department of Medicine, Kurume University School of Medicine / Division of Endoscopy, Kurume University School of Medicine |
| [ Summary ] | The fecal immunochemical test (FIT) is widely accepted as a useful tool for screening colorectal cancer. Although FIT is an effective tool for detecting colorectal cancers, false-negative findings are inevitable, which is its shortcoming, especially for detecting cancer in the right colon, sigmoid colon, and rectum. For colorectal cancer mass screenings, health care professionals should have a good understanding of FIT, endeavor to increase its rate of application, and encourage people to undergo the test annually. A significant difference was not admitted to the depth of invasion, macroscopic classification, pathological type, ly・v, lymph node metastasis. In conclusion, FIT is useful for detecting advanced colorectal cancer; however, it sufficiently cannot detect early-stage colorectal cancer. Thus, an endoscopic screening test in addition to FIT needs to be considered for lesions suited to endoscopic treatment. | |