日本人における食道胃接合部の臨床病理学的検討

Pathology of the Gastroesophageal Junction in Japanese

要旨　食道胃接合部（EGJ）の詳細な検討が可能であった日本人の食道癌手術材料142例を用い，EGJを全割し組織学的検討を行った．胃側および食道側の噴門腺の長さ，慢性胃炎，carditis，食道炎，食道扁平上皮下円柱上皮（esophageal cardiac-type glands）の管腔表面への露出（円柱上皮島）およびBarrett上皮について組織学的検討を行った．short Barrett epithelium（SBE）は50％の症例で認められ，詳細に検討を行えば従来考えられていたより多くの症例で確認できるものと考えられた．また円柱上皮島の存在する群では，存在しない群に比べ，SBEの出現が多い傾向にあり，SBEの形成に円柱上皮島が関与している可能性が示唆された．

　We have examined the gastroesophageal junction in a consecutive series of 142 patients who underwent esophago-gastrectomy for esophageal cancer. Patients with cancer of the distal esophagus were excluded. The entire EGJ was sectioned longitudinally and histological examination was performed. All patients were analyzed for the length of gastric and esophageal cardiac mucosa, chronic gastritis, carditis, columnar epithelial island (CEI) in esophageal squamous epithelium and Barrett's esophagus. Short segment Barrett's esophagus (SBE) was present in 50% of the patients. The presence of SBE was more frequently recognized in patients with CEI than in patients without CEI. We consider that CEI plays an important role in producing the SBE appearance.