通常内視鏡による隆起型の胃腺腫と分化型癌の鑑別診断

Differential Diagnosis of Gastric Adenoma and Protruding, Differentiated Gastric Cancer by Conventional Endoscopy Using White Light

要旨　胃腺腫は腸型腺腫と胃型腺腫に大別される．通常内視鏡検査における腸型腺腫と分化型癌（IIa型早期胃癌）の鑑別診断は，病変の（1）大きさ，（2）色調，（3）表面性状，（4）経時的変化（増大傾向や形状変化の有無）に注目して行う．一方，胃型腺腫と分化型癌（特に胃型胃癌）との鑑別はこれまで十分な知見が得られておらず，胃型腺腫は癌の併存率が高いことから，total biopsyの目的で積極的にESDを行うべきである．

　There are two types of gastric adenomas : the intestinal-type and the gastric-type. For differential diagnosis between intestinal-type adenoma and protruding, differentiated cancer of the stomach（Stages 0-IIa）by conventional endoscopy using white light, the size, color, surface pattern of the lesion, and changes in size and/or shape should be assessed. On the other hand, information on the differentiating features between gastric-type adenoma and protruding, differentiated cancer of the stomach, particularly gastric-type cancer, is limited because gastric-type adenoma is rare. Endoscopic submucosal resection should be performed in gastric-type carcinoma because of its strong association with concurrent cancers.