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Stomach and Intestine(Tokyo) Volume 43, Issue 13 （December 2008）

胃と腸 43巻13号（2008年12月発行）

Japanese English

今月の主題大腸癌の発生・発育進展

主題

疫学，検診からみた大腸癌の発生・発育進展とその特徴 The Characteristics of Progression of Colorectal Cancers from the Point of Epidemiology and Mass Screening 尾田恭 ¹ , 加来英典 ^1,2 , 後藤英世 ¹ , 蓮田究 ¹ , 田中朋史 ¹ , 安永真 ¹ , 伊藤清治 ³ , 大久保尚 ¹ , 服部正裕 ¹ , 藤盛孝博 ⁴ , 佐々木裕 ² Yasushi Oda ¹ , Eisuke Kaku ^1,2 , Hideyo Goto ¹ , Kiwamu Hasuda ¹ , Tomofumi Tanaka ¹ , Makoto Yasunaga ¹ , Kiyoharu Ito ³ , Hisashi Okubo ¹ , Masahiro Hattori ¹ , Takahiro Fujimori ⁴ , Yutaka Sasaki ² ¹服部胃腸科 ²熊本大学大学院医学薬学研究部消化器内科学 ³尾崎医院 ⁴獨協医科大学人体分子病理 ¹Hattori GI Endoscopy and Oncology Clinic, Kumamoto, Japan ²Department of Gastroenterology and Hepatology, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan ³Ozaki Clinic, Kumamoto, Japan ⁴Department of Surgical and Molecular Pathology, Dokkyo Medical University School of Medicine, Tochigi, Japan キーワード：一般人口 , advanced neoplasia , nonpolypoid growth pattern , 早期癌 , 陥凹型 Keyword: 一般人口 , advanced neoplasia , nonpolypoid growth pattern , 早期癌 , 陥凹型 pp.1884-1890

発行日 2008年12月25日 Published Date 2008/12/25

DOI https://doi.org/10.11477/mf.1403101532

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要旨　一般人口に類似した集団を対象に大腸の発生・発育進展について検討した．無症状または一時的腹部症状で，かつ初回検査である8,270名を対象とし，発見される進行癌を除いたadvanced neoplasiaの形態を検討した．発見頻度は，男性で7.9％，女性で3.8％，総数600例であった．形態はポリープ型が75％と多くを占めた．表面型は7％であり，その1/3が陥凹型であった．側方発育型は18％を占めた．同様集団14,817名を対象に発見される早期癌のみでの由来の推定を行った．nonpolypoid growthかつ腺腫残存のないものを陥凹型由来と推定した．陥凹型由来と推定されたのは，男性18.6％，女性27.4％であった．

　Subjects were people 40-79 years of age who underwent first colonoscopy for screening. Among the lesions detected, advanced neoplasias were examined. The proportion of each morphological appearance among advanced neoplasias excluding T2 or more advanced colorectal cancers, were examined. Final study subjects were 8,270 people. Six hundred cases of advanced neoplasia was detected in 7.9％ of men, of 3.8％ in women. Polyp-type occupied 75％. Nonpolypoid type and laterally spreading tumor occupied 7％ (one third of which were depressed type), and 18％, respectively. Estimations of origins were examined among early colorectal cancers detected in 14,817 subjects. The lesions which showed both nonpolypoid growth pattern and no adenomatous components in histology were estimated as de novo cancers. De novo cancers were found in 18.6％ of men and 27.4％ of women.