化学療法の治療効果判定に三次元超音波内視鏡検査が有用であった2型胃癌の1例

Usefulness of Three-Dimensional Ultrasound System for Evaluation of Chemotherapy on Type 2 Gastric Cancer, Report of a Case

要旨　患者は80歳，女性．食思不振，体重減少を認め，当院を紹介された．胃内視鏡検査で，体上部に2型胃癌が認められた．患者と家族との協議の結果，化学療法を選択されたため，CDDP，5-FU，LVによる治療を行った．治療2か月後の胃X線検査では，胃癌は73.8％(47×46mm→27×21mm)の縮小を認め，治療効果判定はaPRと判定した．また，三次元超音波内視鏡検査により病変を立体的に捉え，体積計測による治療効果判定を行った．治療前では，病変は胃の長軸方向で35mm，最大断面積309mm²，体積11.6cm³であった．治療2か月後では長軸方向で23mm，最大断面積50mm²，体積3.5cm³であり，体積における縮小率は69.5％であった．三次元超音波内視鏡検査により腫瘍の計測は可能であり，客観的な治療効果判定に有用な検査法であると考えられた．

　An 80-year-old woman was admitted to our hospital with the complaint of anorexia and weight-loss. Screening endoscopic examination of the upper gastrointestinal tract showed type 2 advanced gastric cancer on the posterior wall of the upper body. The size of the lesion by roentgenographic examination was 47 × 46 mm. This lesion was observed to be 35 mm in size, 309 mm² in the largest area, 11.6 cm³ in volume according to a three-dimensional ultrasound system. After chemotherapy, gastric cancer was reduced. Tumor reduction rate was 73.8% by roentgenographic examination and 69.8% by three-dimensional ultrasound examination. The three-dimensional ultrasound system was able to measure tumor size. It was thought that this system was useful for an objective estimation of chemotherapy on gastric cancer.