食道粘膜癌の初期浸潤像の診断―拡大内視鏡の立場から

Endoscopic Findings of Minute Invasion of Superficial Esophageal Squamous Cell Carcinoma

要旨　日本食道学会では，より簡便な拡大内視鏡分類を作成することを目的とし，「拡大内視鏡による食道表在癌深達度診断基準検討委員会」を設立し，日本食道学会分類を作成した．本論文では，日本食道学会分類に基づいて拡大内視鏡所見と食道扁平上皮癌の深達度診断の相関を検討した．陥凹内隆起を呈する症例では色調と血管異型が深達度と相関があり，白色隆起は血管異型にかかわらず深達度T1a-EP～LPMであったが，赤色隆起ではB1血管を呈する場合はT1a-EP～LPM，B2血管ではT1a-MM～SM1であった．

　A new classification of magnified endoscopic classification of superficial esophageal SCC（squamous cell carcinoma）was established by the Japan esophageal association. The micro vascular pattern was classified into B1, B2 and B3. B1 : loop like vessels. B2 : non-loop vessels. B3 : Vessels three times or more thicker than B2. There are some cases with elevation within flat depressed lesion（0-IIc＋IIa）invading the MM（muscularis mucosae）. A white elevated area doesn't invade the Muscularis mucosae regardless of vascular pattern. However, a red elevated area with B2 vascular pattern invaded the MM or SM1. Therefore, this new classification of the Japan Esophageal Association is useful for the detection of the minute invasion site of superficial esophageal SCC.