大腸腺腫の経過例の検討

Progress of Colorectal Adenomas

要旨　6か月以上の期間にわたって内視鏡的に経過観察した腺腫を対象に，肉眼形態，大きさについて検討した．対象は199病変で平均観察期間は18か月，初回観察時の肉眼形態はⅠp8病変，Ⅰsp42病変，Ⅰs47病変，Ⅱa77病変，Ⅱa＋dep20病変，Ⅱb1病変，LST4病変，LSTを除くものの腫瘍径は10mm以下で，微小病変が隆起型で71％，表面型で97％を占めた．肉眼形態について明らかな変化はないが，Ⅱa＋depで隆起傾向のみられるものがあった．腫瘍径については1mmまでの変化のものが95％を占め，変化のあったとしたものも誤差による可能性が高いと思われた．治療した146病変に癌はなく，すべて腺腫であった．表面隆起型で5mm程度の大きさでamorphismのないⅢ_L pitを示すものは経過観察でよいと思われた．

　The shape and size of colorectal adenomas which were followed up for six months or longer, were investigated. 199 lesions were studied for 18 months on the average. The type of lesions which were detected at first were Ⅰp (eight cases), Ⅰsp (42 cases), Ⅰs (47 cases), Ⅱa (77 cases), Ⅱa ＋ dep (20 cases), Ⅱb (one case) and LST (four cases). The size of all cases except LST detected, at first were 10 mm or smaller, and 71% of the protruted type (Ⅰp, Ⅰsp, Ⅰs) and 97% of superficial type (Ⅱa, Ⅱa ＋ dep, Ⅱb) were 5 mm or smaller. Most cases had not changed in size and, even in those that had changed, the changes were thought to be due to an error of measurement. There were no cancer in 146 cases removed by colonoscopically. The conclusion is that adenoma of the superficial type which are 5 mm or smaller and adenoma of the protruded type which are 10 mm or smaller can be left and followed up.