short segment Barrett's esophagusの診断

Diagnosis of Short Segment Barrett's Esophagus

要旨　short segment Barrett's esophagus（SSBE）を検討するうえで重要なことは，Barrett粘膜ないしBarrett食道の定義である．われわれはBarrett食道を“胃側より連続して全周性に2cm以上食道に存在する円柱上皮”と定義している．したがって，SSBEは“胃側より連続して食道に存在する円柱上皮で，その長さが2cm未満の部分を有するもの”と定義される．SSBEは下部食道縦走血管を指標とすることにより，内視鏡で明確に診断できる．このようにして診断されたSSBEは上部消化管内視鏡検査を行った連続9,018例のうち約1/3の症例に認められた。SSBEにもBarrett腺癌が発生し，総数としては典型的Barrett食道に生じるものと比べても決して少なくないことから，注意深い観察と一定間隔ごとの経過観察が必要な病変である．

　When short segment Barrett's esophagus (SSBE) is examined, it is important to know exactly what the definition of Barrett's esophagus is. We define Barrett's esophagus “the columnar mucosa which extends continuously more than 2 cm in the circumference of the esophagus from the stomach”. Therefore, SSBE is defined as “the coumnar mucosa which extends in the esophagus continuously from the stomach but its length is less than 2 cm”. SSBE can be clearly diagnosed using endoscopy as the columnar mucosa lying on the longitudinal vessels in the lower esophagus. We recognized SSBE in one third out of a consecutive 9,018 cases in which we performed upper gastrointestinal endoscopy.

　Barrett's adenocarcinomas occur also in SSBE. Periodic endoscopic observation of SSBE is necessary, because there are more patients with SSBE than those with typical Barrett's esophagus even though the rate of occurrence of the adenocarcinomas in SSBE is very low in comparison the occurrence rate of adenocarcinomas in case of Barrett's esophagus.