造影EUS検査による進行胃癌原発巣の化学療法効果判定

Evaluation of the Response to Chemotherapy in Advanced Gastric Cancer by Contrast-enhanced Harmonic EUS Using Sonazoid®

要旨　胃癌化学療法の効果判定として原発巣評価の重要性は本邦で広く認識されている．今回，筆者らはSonazoid^®を用いた造影EUS検査を施行し，胃癌原発巣の化学療法効果判定を行い，その有用性について検討した．造影EUS検査は，腫瘍の形態的変化だけでなく，腫瘍のvascularityを評価できる新しい検査方法であり，従来の効果判定法である内視鏡検査などで判定困難な病変でも効果判定が可能である．胃癌を含む固形癌においては血管新生と患者の生命予後，転移との間に有意な相関関係があり，造影EUS検査による腫瘍のvascularityの正確な評価は，患者の生命予後，転移の予測に寄与するものと考えられる．

　The importance of evaluation of the response to chemotherapy in primary gastric tumor is accepted widely in Japan. In this study, we evaluated the response to chemotherapy in primary gastric tumor by contrast-enhanced harmonic EUS（CEH-EUS）using Sonazoid^® and examined the utility of CEH-EUS using Sonazoid^®. CEH-EUS using Sonazoid^® is a new method of evaluating primary gastric tumor by not only a change of its form but also its vascularity and we are able to evaluate the response to chemotherapy by CEH-EUS using Sonazoid^® in primary gastric tumor, which is difficult to evaluate by conventional endoscope and barium roentgenograms. Also, there is a significant association between tumor angiogenesis and prognosis of patients and metastasis by various solid tumors including gastric cancer and we think that correct evolution of tumor vascularity helps in the prognosis of patients and metastasis.