食道癌の発育進展を考慮したスクリーニング法

An Efficient Screening of Esophagus Suitable for the Character of Early Esophageal Carcinoma

要旨　内視鏡的粘膜切除術で食道粘膜癌が治療できる時代になった．このような病巣を効率よく見つけだすには，小さいヨード不染帯の多発症例，食道癌合併頻度の高い疾患の注意深い観察，更に皮膚の老化と同じ病態が食道粘膜に起きていると解釈したうえでの観察が必要である．粘膜癌では同じ状態が3～4年持続すると推定されている．このような時期にいかに効率よくスクリーニングする方法を確立するべきかが本論文の要旨である．

　The time has come when mucosal esophageal carcinoma can be treated by endoscopic mucosal resection. In order to detect these mucosal carcinomas efficiently, it is necessary to observe carefully ; (1) the advent of multiple small non-stained areas, (2) such a high risk complication for esophageal carcinoma as achalasia, which often leads to esophageal carcinoma, (3) the esophageal mucosa which is supposed to have the same senile symptoms as that of the skin. Mucosal esophageal carcinoma is considered to remain in a stable condition for 3 to 4 years. The aim the authors for this paper is to establish an efficient screening method to detect mucosal esophageal carcinomas during this stable period of 3 to 4 years.