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要旨 当院における通常内視鏡,およびインジゴカルミンを用いた色素撒布後の内視鏡による早期胃癌の範囲診断能,および診断を困難にさせる因子について検討した.全385病変を検討し,通常内視鏡で境界明瞭と判断したものは72.2%,色素撒布後の内視鏡では92.2%であった.最終的に正確な範囲診断が可能であったものは78.4%で,その範囲診断を誤らせる因子として“病変長径31mm以上”,“主な組織型が未分化型”,“粘膜表層に分化型優位の混在あり”,“潰瘍瘢痕あり”,“0 IIb成分あり”が統計学的に有意であった.このような病変に対しては通常内視鏡だけでは限界がありAIMやNBIなどを活用した確実な範囲診断が不可欠であると考える.
We evaluated the diagnostic accuracy of a range of early gastric cancers using conventional endoscopy and chromoendoscopy after indigo-carmine dye and researched the factors that decrease the accuracy of diagnosis.
We evaluated data in 385 lesions. Among those lesions, the rates of definite demarcation of early gastric cancers using conventional endoscopy and those of chromoendoscopy after indigo-carmine dye were 72.2% and 92.2%, respectively. The final diagnostic accuracy rate in the where range of cancers we examined was 78.4%, and the significant factors which decrease the diagnostic accuracy rate were “when the diameter of the tumor exceeds 31mm”, “when the main type of differentiation is undifferentiated type”, “when there is mixed differentiation, in which differentiated type dominates, present in the surface of the mucosa”, “when there is ulcer scar”, “when the lesion is 0 IIb”.
In such lesions, there are some limitations encountered in using conventional endoscopy with or without indigocarmine dye, so it is considered desirable that we diagnose definitely using AIM or NBI.
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