胃癌組織型診断―VS classification systemに沿った形態所見分類（案）

Histopathological Diagnosis of Gastric Cancer Using Magnifying Endoscopy Combined with the Narrow Band Imaging: a Proposal of Classification for Morphological Findings According to VS Classification

要旨　早期胃癌の組織型診断に関する狭帯域光観察併用拡大内視鏡所見について，VS classification systemに沿った形態所見分類を考案し検討した．隆起性病変では分化度の低下に従い，不整な微小血管，表面微細構造の不明瞭化，不整な表面微細構造，VSの不一致が多く認められ，微小血管のネットワーク形成の割合が低下する傾向がみられた．陥凹性病変では，未分化型で不整でない表面微細構造，蛇行した微小血管，いびつな微小血管の有所見率が高く，ネットワーク形成の割合は顕著に低かった．今回の検討ではネットワーク形成の有無と表面微細構造の整・不整を組み合わせることで，陥凹性病変では分化型癌，未分化型癌の鑑別ができる可能性を示すことができた．

　We proposed a classification for morphological findings of gastric cancer according to VS classification using magnifying endoscopy combined with narrow band imaging and investigated the relationship between the morphological findings and histopathological type of gastric cancer. Irregular microvascular pattern（V）, absent microsurface pattern（S）, irregular S and VS discordance were more frequently seen and the network formation of V component was less frequently seen in the more undifferentiated histopathological type of protruded gastric cancer. Irregular V, tortuous type V morphology and bizarre type V morphology were more frequently seen and network formation of V component was less frequently seen in depressed undifferentiated adenocarcinoma compared to depressed differentiated adenocarcinoma. This study indicated the possibility of optical biopsy of gastric cancer using the combination of the network formation of V component and the irregularity of S component.