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 44, Issue 11 （October 2009）

胃と腸 44巻11号（2009年10月発行）

Japanese English

今月の主題食道小扁平上皮癌の診断

主題

食道小扁平上皮癌のX線診断 Radiographic Diagnosis of Small Squamous Cell Carcinomas of the Esophagus 高木靖寛 ¹ , 長浜孝 ¹ , 平井郁仁 ¹ , 宮岡正喜 ¹ , 別府孝浩 ¹ , 槙信一朗 ¹ , 八尾建史 ¹ , 松井敏幸 ¹ , 田邊寛 ² , 池田圭祐 ² , 大重要人 ² , 太田敦子 ² , 西俣伸亮 ² , 原岡誠司 ² , 岩下明徳 ² , 富安孝成 ³ , 前川隆文 ³ Yasuhiro Takaki ¹ , Takashi Nagahama ¹ , Fumihito Hirai ¹ , Masaki Miyaoka ¹ , Takahiro Beppu ¹ , Shinichirou Maki ¹ , Kenshi Yao ¹ , Toshiyuki Matsui ¹ , Hiroshi Tanabe ² , Keisuke Ikeda ² , Kaname Oshige ² , Atsuko Ota ² , Nobuaki Nishimata ² , Seiji Haraoka ² , Akinori Iwashita ² , Takashige Tomiyasu ³ , Takafumi Maekawa ³ ¹福岡大学筑紫病院消化器科 ²福岡大学筑紫病院病理部 ³福岡大学筑紫病院外科 ¹Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan ²Department of Pathology, Fukuoka University Chikushi Hospital, Chikushino, Japan ³Department of Surgery, Fukuoka University Chikushi Hospital, Chikushino, Japan キーワード：食道表在癌 , 小扁平上皮癌 , X線診断 Keyword: 食道表在癌 , 小扁平上皮癌 , X線診断 pp.1713-1722

発行日 2009年10月25日 Published Date 2009/10/25

DOI https://doi.org/10.11477/mf.1403101779

PDF(1496KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside
参考文献 Reference
サイト内被引用 Cited by

要旨　当科で精密X線検査が行われた表在型食道扁平上皮癌139例143病変を隆起型（44病変）と平坦陥凹型（99病変）に分類し，小扁平上皮癌のX線正面像の描出能およびその特徴について検討した．結果，隆起型M1，M2癌の描出能は11mm以上で100％（6病変中6病変），10mm以下の小病変も80％（5病変中4病変）が描出可能であった．平坦陥凹型M1，M2癌では31mm以上の病変でも描出率は73％（11病変中8病変）で腫瘍径が小さくなるにつれ低率となり，10mm以下の小病変では50％（8病変中4病変）と隆起型に比べ描出能が悪かった．腫瘍径と上皮内癌の病理学的事項も含めた検討からは，10mm以下のM1癌および腫瘍径がそれ以上であっても非全層置換型のM1癌の描出率が悪く，X線検査の限界と考えられた．一方，10mm以下の陥凹型M3以深癌4病変は全例が描出可能であり，辺縁隆起を伴う濃い境界明瞭な陰影斑が認められ，深達度診断に有用な所見であった．これらの結果から，転移のリスクのある小さな陥凹型癌の存在範囲・深達度診断にX線検査は有用と考えられた．

　We classified 143 lesions from 139 cases of superficial squamous cell carcinoma of the esophagus that had been radiographically examined in detail in our department into the protruding type（44 lesions）and flat-and depressed-types（99 cases）, and assessed the ability of frontal radiographs to visualize small squamous cell carcinomas and their properties. The results showed that they were capable of visualizing 6 lesions out of 6（100％）of the protruding type of M1-2 cancers that measured 11 mm or more in diameter and 4 lesions out of 5（80％）of the small lesions measuring 10 mm or less in diameter. The visualization rate for flat-and depressed-type M1-2 cancers was 8 lesions out of 11（73％）for lesions measuring 31 mm or more in diameter and decreased as the tumor diameter became smaller. Ability to visualize small lesions measuring 10 mm or less in diameter was 4 lesions out of 8（50％）, which was poorer than for the protruding type. The non-visualizing clinico-pathological factor of early esophageal cancer was M1 cancer measuring 10mm or less in diameter and was non-total layer replacement type M1 cancers of any tumor size. By contrast, the radiographs were capable of visualizing all 4 of the depressed-type M3 or deeper cancers 10 mm or less in diameter. Dense barium fleck with a clearly demarcated border and a marginal elevation were observed, and they were useful findings for diagnosing depth of invasion. Radiography examinations appeared to be useful for diagnosing the presence and depth of invasion of small depressed-type cancers with a risk of metastasis.