胃の拡大内視鏡による3学会合同診断体系

A Multi-institutional Cooperative Effort to Develop a Diagnostic Algorithm for Early Gastric Cancer Using Magnifying Endoscopy

要旨●これまでに，拡大内視鏡検査は早期胃癌の診断に有効であることが知られている．しかし，拡大内視鏡所見の用語や定義，それらの分類，診断基準については統一されたものはない．そこで，日本消化管学会，日本消化器内視鏡学会，日本胃癌学会の3学会の合同で，早期胃癌の拡大内視鏡による診断体系が作成された．早期胃癌の診断は，通常内視鏡検査の白色光観察で疑い病変を見つけ出すことから始まる．次に拡大内視鏡を用いて，背景粘膜と病変の境界線の存在を診断する．demarcation lineが存在し，かつ不整な微小血管構築像または不整な表面微細構造が認められれば，早期胃癌と診断がつけられる．

　Magnifying endoscopy is a highly accurate technique for the detection of EGC（early gastric cancer）. However, the criteria and algorithms for the diagnosis and classification of EGC have not been unified. Therefore, a magnifying endoscopy simple diagnostic algorithm for EGC was established jointly by the Japanese Gastroenterological Association, Japan Gastroenterological Endoscopy Society, and Japanese Gastric Cancer Association. The first step in diagnosing EGC is to identify a suspicious lesion using conventional white-light endoscopy. The next step is the identification of a demarcation line between the suspicious lesion and background mucosa. Finally, the detection of an irregular microvascular pattern or an irregular microsurface pattern can help diagnose a suspicious lesion as EGC.