食道癌診断におけるX線検査の有用性―診断の立場から：内視鏡と比較して

Comparative Usefulness of Radiology and Endoscopy in Diagnosing Superficial Cancer of the Esophagus

要旨　食道表在癌診断におけるX線検査の有用性を内視鏡検査との比較で述べた．X線検査は撮影技術次第で内視鏡検査に劣らない所見の描出能を発揮し，病型診断や深達度診断ではむしろ内視鏡に勝る診断能がある点を強調した．今後，食道表在癌に対する内視鏡治療はますます盛んになるものと予想されるが，適応症例と非適応症例の鑑別に際してX線診断は有用な役割を果たしうるものと考える．

　In present-day diagnostic technology for superficial cancer, endoscopy has been preferred unanimously. This study reconsiders the usefulness of radiology especially for the diagnosis of superficial cancer of the esophagus. Using highly-developed X-ray techniques, radiology has proved more effective than endoscopy for the visualization of lesions especially with regard to diagnosis of disease type and cancerous depth. A series of radiograms focusing on both the frontal view and profile view of lesions can provide a wealth of information concerning disease type and depth of invasion superior to that obtainable by endoscopy. The categorical cancerous-depth diagrams based on such profile deformities as “saucer-shaped” or “wedge-shaped”, which we have advocated so far as evident in the literature, has proved remarkably useful in the diagnosis of m3 and sm1 lesions. Accodingly, the current methodology for the diagnosis of superficial cancer of the esophagus needs to be re-evaluated. For thorough treatment for such lesions, radiology combined with endoscopy is indispensable.