INTESTINE Vol.25 No.4(6)


特集名 大腸Ⅱc─革命のその後
題名 大腸陥凹型病変に対する認識の世代間・施行医間格差
発刊年月 2021年 12月
著者 山野 泰穂 札幌医科大学附属病院消化器内視鏡センター
【 要旨 】 陥凹型病変は発見頻度が低く,希少病変であるとの認識があるが故に若い世代において意識が薄れている印象がある.そこで過去5年間の内視鏡診断データベースを用いて腺腫・早期癌および陥凹型病変に対する検査精度を解析し,施行医の世代間格差を検討した.その結果,腺腫・早期癌に対するpolyp detection rate(PDR),the number of polyp per colonoscopy(PPC)は世代が上になるほど概ね上昇する傾向が認められ,陥凹型病変の正診率およびthe number of depressed lesion per colonoscopy(DPC)も同様に上昇を示した.これら三つの検査精度値に相関が認められたことで,検査精度と経験値が陥凹型病変の発見には重要な因子と考えられた.また同じ検査フィールド内,同世代内でも検査精度に個人差が存在することから,改めて陥凹型病変が看過されていることが示唆された.
Theme Depressed type colorectal cancer -- Revolution and since then
Title Investigating inter-observer and -generation gaps between endoscopic quality indicators for depressed type of colorectal tumor
Author Hiro-o Yamano Department of Gastroenterology and Hepatology, Sapporo Medical University Hospital
[ Summary ] The depressed type of colorectal tumor is generally considered to be a rare lesion. Therefore, I believe that the younger generation is less aware of this disease. Therefore, we analyzed the endoscopic quality indicators to diagnose adenoma/early cancer and depressed type of colorectal tumor using the endoscopic diagnostic database from the past 5 years, and examined the inter-observer and -generation gaps. As a result, the polyp detection rate (PDR) and number of polyp per colonoscopy (PPC) for adenomas/early cancer exhibited an increasing trend with each generation. The correct diagnosis rate of depressed lesions and number of depressed lesions per colonoscopy (DPC) were found to be correlated. A correlation was also found between these three indicators, suggesting that the indicators and experience were the important factors for detecting depressed lesions. Additionally, since there were individual differences in the quality indicators within the same inspection field and generation, it was possible to reconfirm that the depressed lesions were overlooked.
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