隆起型の胃腺腫と分化型癌の内視鏡的鑑別診断—拡大内視鏡診断

Differential Diagnosis of Adenoma and Well-differentiated Adenocarcinoma of the Stomach with Magnifying Endoscopy

要旨　病理組織学的に腺腫と診断された7例と高分化管状腺癌と診断された18例のNBI拡大内視鏡像を比較検討した．ネットワーク血管の不整は癌に（p＝0.040），びまん性に存在するLBC（light blue crest）は腺腫に（p＝0.032）有意に多く認めた．顆粒・乳頭状構造，WOSの出現・消退の変化，経過中の拡大像の変化はすべて癌であった．典型的な腺腫のNBI拡大内視鏡像は整なネットワーク血管に囲まれLBCを認める像と考えられた．

　We analyzed images of gastric adenoma（7）and well-differentiated adenocarcinoma lesions（18）obtained with NBI（narrow band imaging）-magnifying endoscopy. Irregularity of the microvascular network was observed more often in adenocarcinoma than in adenoma（p＝ 0.04）; however, appearance of a LBC（light blue crest）was observed more often in adenoma than in adenocarcinoma（p＝0.032）. Granular or papillary structures, appearance and disappearance of white opaque substance, and changes in magnifying endoscopic imaging were observed in adenocarcinoma. The characteristic features of adenoma observed with NBI-magnifying endoscopy were a regular microvascular network and LBC.