Japanese
English
- 有料閲覧
- Abstract 文献概要
- 1ページ目 Look Inside
- 参考文献 Reference
要旨●本邦ではCrohn病関連消化管癌の44%が肛門管癌であることが知られているが,進行例での予後が不良であり,サーベイランスによる早い病期での診断が望まれる.2015年より厚労省研究班の多施設共同研究として,直腸肛門病変発症後10年以上の症例を対象とした内視鏡下あるいは麻酔下肛門精査での生検・細胞診を軸としたサーベイランスプログラムの検証が行われた.その結果,5%と高頻度に悪性腫瘍が診断され,その有用性が示された.早期癌で診断できることはいまだ少なく,治療可能な病期での診断が現状での目標となっているが,密なサーベイランスを行うべき癌化の高リスク群を明らかにしつつ,早期癌の肉眼・内視鏡所見を明らかにして,早期診断例の増加を目指すのが今後の課題である.
In Japan, anal canal carcinomas account for 44% of Crohn's disease-related gastrointestinal cancers, and because the prognosis is poor in advanced cases, its diagnosis at an early stage through surveillance is desirable. A surveillance program involving biopsy and cytology during endoscopic examination or examination under anesthesia for patients with anorectal lesions occurring at >10 years after onset of Crohn's disease was validated in a multicenter study that began in 2015 and supported in part by Health and Labor Sciences Research Grants for Research on Intractable Diseases from the Ministry of Health, Labor and Welfare of Japan. As a result, the diagnostic rate of malignant tumors reached 5%, indicating the usefulness of the program. The current situation is that diagnosis can be made at a stage when the disease is treatable, and diagnosing cancers at an early-stage is still not possible. The future challenge is to identify high-risk groups for cancer requiring short-term surveillance and to clarify the gross and endoscopic findings of early-stage cancer in order to increase the number of cases diagnosed in the early stage.

Copyright © 2025, Igaku-Shoin Ltd. All rights reserved.