雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Stomach and Intestine(Tokyo) Volume 42, Issue 5 （April 2007）

胃と腸 42巻5号（2007年4月発行）

Japanese English

特集消化管の拡大内視鏡観察2007

各論 4. 大腸

1) 大腸腫瘍・非腫瘍性病変の鑑別 Differential Diagnosis of Non-neoplastic and Neoplastic Lesions Using Magnifying Chromoendoscopy 松田尚久 ¹ , 斎藤豊 ¹ , 菊地剛 ¹ , 横井千寿 ¹ , 桐山真典 ¹ , 鈴木晴久 ¹ , 草野央 ¹ , 福澤誠克 ¹ , 瀧澤初 ¹ , 斉藤大三 ¹ , 傅光義 ^2,3 , 佐野寧 ^2,4 , 藤井隆広 ⁵ Takahisa Matsuda ¹ , Yutaka Saito ¹ , Tsuyoshi Kikuchi ¹ , Chizu Yokoi ¹ , Shinsuke Kiriyama ¹ , Haruhisa Suzuki ¹ , Chika Kusano ¹ , Masakatsu Fukuzawa ¹ , Hajime Takisawa ¹ , Daizo Saito ¹ , Kuang-I Fu ^2,3 , Yasushi Sano ^2,4 , Takahiro Fujii ⁵ ¹国立がんセンター中央病院内視鏡部 ²国立がんセンター東病院内視鏡部消化器科 ³獨協医科大学放射線科 ⁴佐野病院消化器センター ⁵藤井隆広クリニック ¹Division of Endoscopy, National Cancer Center Hospital, Tokyo ²Division of Digestive Endoscopy and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan ³Department of Radiology, Dokkyo University School of Medicine, Tochigi, Japan ⁴Gastrointestinal Center, Sano Hospital, Kobe, Japan ⁵TF Clinic, Tokyo キーワード：大腸腫瘍 , 拡大内視鏡 , pit pattern診断 Keyword: 大腸腫瘍 , 拡大内視鏡 , pit pattern診断 pp.781-785

発行日 2007年4月26日 Published Date 2007/4/26

DOI https://doi.org/10.11477/mf.1403101082

PDF(1897KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside
参考文献 Reference

要旨　大腸拡大内視鏡診断（pit pattern診断）は，病変の質的診断（腫瘍・非腫瘍性の鑑別）において非常に有用である．大腸206病変を対象としたprospective studyの結果から，質的診断における正診率は，通常観察・色素観察・拡大内視鏡観察それぞれにおいて84.0％・89.3％・95.6％であり，通常観察に拡大観察を加えることで，5～10％の質的診断能の上乗せ効果が見込まれる．また，retrospectiveな解析から，拡大内視鏡の導入により，非腫瘍性病変に対する内視鏡摘除件数は約1/4に抑えられる可能性があり，医療経済効果も十分に期待できる．

　Differential diagnosis of malignant and benign colorectal lesions, using colonoscopy is of cardinal importance. Magnifying colonoscopy permits observation of the fine pit pattern, which may result in more accurate diagnosis regarding colorectal lesions at an earlier stage. We have conducted a prospective study to examine whether magnification and/or indigo carmine dye spraying is more reliable than the conventional view for such differential diagnosis. The overall diagnostic accuracy of magnification in addition to chromoendoscopy using indigo carmine was 95.6％, which is 10％ and 5％ more reliable than conventional endoscopy and chromoendoscopy, respectively. Additionally, that method was significantly superior to conventional endoscopy and chromoendoscopy (p＜0.0001 and p＝0.0152). Therefore, based on the results, we are able to conclude that the combination of magnifying colonoscopy and chromoendoscopy is the most reliable method for separating non-neoplastic at the present time from neoplastic lesions of the colon and rectum.