食道表在癌の初期浸潤像の診断―X線の立場から

Diagnosis of Superficial Esophageal Cancer Using X-ray Images of Early Infiltration

要旨　食道粘膜癌の局所浸潤部におけるX線所見について，38例（T1a-LPM癌：17例，T1a-MM癌：17例，SM1癌：4例）を見直し検討した．その結果，31例（82％）は透亮像を呈して浸潤し，陰影斑のみによるものは7例（18％）と頻度が低かった．深達度別の透亮像の大きさは，T1a-LPM癌では1～3mmと4～6mmが半数ずつで，T1a-MM癌では2～8mmと様々であった．T1b-SM1癌の4例中3例は4～6mmであった．粘膜癌の局所浸潤部の診断には，X線の弱～中伸展像における透亮像に着目することが重要と考えられた．

　The X-ray findings showing the locations of local infiltration of esophageal mucosal cancer in 38cases（T1a-LPM cancer : 17cases ; T1a-MM cancer : 17cases ; SM1 cancer : 4cases）were reviewed and examined. Infiltration with filling defect was observed in 31cases（81％）, and only 7cases had images comprised only of blotchy shadows（18％）. In T1a-LPM cancer, approximately 50％ of filling defects were measured as 1-3mm and the remaining 50％ were 4-6mm, while the size of the filling defects were from 2mm to 8mm in T1a-MM cancer. Three of the four cases of SM1 cancer had values between 4 and 6 mm. It is important to focus on the filling defects in X-ray images of slightly to moderately inflated esophagus for diagnosis of local infiltration of mucosal cancer.