| 特集名 | 小さな(大きさ10mm以下)ポリープの取扱い --処置すべきか，フォローアップか | |
|---|---|---|
| 題名 | どう扱うか，小さなポリープ (3) 人間ドックにて発見された大腸ポリープの分析 | |
| 発刊年月 | 2000年 05月 | |
| 著者 | 山地 裕 | 東京大学医学部消化器内科 / 亀田総合記念病院消化器内科 |
| 【 要旨 】 | 要旨はありません。 | |
| Theme | Strategy of managing small colorectal polyps | |
|---|---|---|
| Title | The risk for colorectal cancers related to the size of colorectal adenomas | |
| Author | Yutaka Yamaji | Department of Gastroenterology, Faculty of Medicine, University of Tokyo / Department of Gastroenterology, Kameda General Hospital |
| [ Summary ] | We conducted 66,565 of total colonoscopy on 23,618 Japanese subjects at our annual medical health check-up from 1983 through 1999. The subjects had not been screened either for their symptoms or by fecal occult blood tests, and undertook colonoscopy as their first-choice for examination to check their colorectal lesions. During each examination, all of the polyps >=5mm and the lesions <5mm suspected of neoplasia were resected. All the subjects were encouraged to have annual follow-up examinations by total colonoscopy. The following results were found according to the size of lesions. (1) A total of 15,357 neoplastic lesions were found. Among them, 9,537 were <5 mm (malignant = 3, 0.03 %), 4,580 were 5 - 9mm (malignant = 34, 0.7 %), and 1,240 were >=10 mm (malignant = 210, 16.9 %). (2) Out of 10,211 subjects with no neoplastic lesions found in the first examination, 34 subjects (0.3 %) developed new colorectal cancers during the follow-up examinations. On the other hand, 4 out of 1,149 subjects (0.3 %) with only adenomas <5mm, 8 out of 874 subjects (0.9 %) with adenomas 5 - 9mm at most, and 5 out of 330 subjects (1.5 %) with adenomas >=10mm developed colorectal cancers after the initial adenomas had been endoscopically resected. The risk for colorectal cancers both in the present and in the future increased according to the size of the colorectal adenomas. However, adenomas <5mm seemed to present only a negligible risk. |
|