大腸癌の深達度診断—通常内視鏡診断

Diagnosis of Depth of Invasion of Colorectal Cancers by Conventional Endoscopic Evaluation

要旨●内視鏡所見により大腸癌の術前深達度診断を正確に行うことは，内視鏡医にとって必要不可欠な能力である．特に深達度が粘膜下層深部浸潤以深では内視鏡治療適応外となるため，正確な深達度診断が求められる．本稿では，粘膜下層深部浸潤を疑う所見を中心に，病変径，肉眼形態，空気変形や可動性，ひだ集中所見などに着目した観察のポイントを，通常観察（白色光）とインジゴカルミン色素撒布像で示していく．

　Endoscopic diagnosis of the depth of invasion of colorectal cancer is crucial for endoscopists, as it considerably influences the subsequent treatment strategies. Particularly distinguishing deep invasive submucosal cancer, where endoscopic treatment is not indicated, from mucosal or minimally invasive submucosal cancer is essential. This section highlights the key observation points, including lesion size, macroscopic morphology, deformation and mobility under insufflation, and fold convergence findings, focusing on conventional white-light imaging and indigo carmine dye spraying techniques.