経鼻内視鏡スクリーニングの実態と問題点―人間ドックの立場から

Present Situation and Problems of Gastric Cancer Screening by Transnasal Endoscopy in Our Health Check-up Center

要旨　2002年に宮脇らが極細径スコープによる経鼻内視鏡検査を始めて10年が経過しようとしている．この間に経鼻内視鏡は急速な普及を遂げるとともに，そのスコープ性能，特に画質は長足の進歩を遂げている．しかしスコープの極細径化や経鼻挿入によって生じたいくつかの問題点を抱えているのも事実である．当院では2007年に経鼻内視鏡センターを開設し，独自の工夫を加えながら人間ドックを中心に経鼻内視鏡を活用している．現在使用している極細径スコープEG-530NWやEG-580NWの画質は経口内視鏡に匹敵するものであり，当院人間ドックでの経鼻内視鏡胃癌発見率も経口内視鏡のそれと差がないという結果であった．経鼻内視鏡の特性を熟知したうえで検査を行えば，スクリーニングには十分な診断能を有する検査法であると考えられる．

　Almost 10 years have passed since transnasal endoscopy（TNE）was started by Miyawaki et al. using the ultrathin endoscope. TNE has been gaining popularity in Japan and the performance of the transnasal endoscope has remarkably improved, especially in its quality of images during that time. However there are actually some problems resulting from the ultrathin diameter of the endoscope. In 2007, a TNE center was established in our hospital and we are coming up with some original ideas for performing TNE in this center. Now we are using EG-530NW and EG-580NW, the 4th-generation transnasal endoscope, its resolution is considered to be equally matched with that of the conventional endoscope. Furthermore there is no difference in the detection rate of gastric cancer between transnasal endoscopy and conventional endoscopy in our health check-up center. TNE has enough diagnostic capability in screening for gastric cancer, after the marked characteristics of transnasal endoscope have been understood.