日本食道学会拡大内視鏡分類と深達度―深達度診断におけるB3血管の意義

Usefulness of a New Classification by the Japan Esophageal Society to Predict the Depth of Invasion of Esophageal Cancer: Type B3 Vessels

要旨　本稿においては，B3血管のSM2以深浸潤病変の予測に対して，診断能の検討を行った．当センターにて2001年7月～2013年6月までに内視鏡的・外科的治療を行い，拡大内視鏡所見の検討が可能であった464病変を対象とした．B3血管の感度，特異度，PPV，NPV，正診率はそれぞれ56.9％，99.5％，95.3％，92.6％，92.6％であった．B3血管はほぼ確実なT1b-SM2以深への浸潤を予測する所見であると考えられた．しかし，T1b-SM2以深浸潤癌の45.1％の症例においてB3血管が陰性であり，主にB2血管を有する症例に対する診断ストラテジーの確立が課題である．

　The aim of this study was to evaluate the correlation between B3 pattern vessels of the magnifying endoscopic classification of the Japan Esophageal Society and T1b-SM2/SM3 invasion. We retrospectively evaluated 464 esophageal carcinoma lesions that were endoscopically or surgically resected in our hospital from July 2001 to June 2013. Sensitivity, specificity, PPV（positive predictive value）, negative predictive value, and accuracy of B3 pattern vessel for diagnosis were 56.9％, 99.5％, 95.3％, 92.6％, and 92.6％, respectively. Lesions that had B3 pattern vessels were highly likely to be T1b-SM2/SM3 lesions. However, the frequency of the lesions that were negative for B3 pattern vessels was 43.1％. Therefore, it is necessary to provide evidence of the diagnostic strategy for such lesions that have mainly B2 pattern vessels.