消化管非腫瘍性疾患における免疫組織化学染色および特殊染色

Immunohistochemical Stains and Special Stains in Non-neoplastic Lesions of the GI Tract

要旨●消化管非腫瘍性疾患の病理診断の基本となるのは，HE染色による診断で，免疫染色・特殊染色は補助手段にすぎないが，疾患・病変によっては免疫染色・特殊染色が非常に有用であるものや，必須であるものも存在する．本稿では，消化管非腫瘍性疾患の病理診断における免疫染色および特殊染色を，有用性が高いものと必須であるものを中心に，疾患・病変別に解説した．非腫瘍性疾患は感染症を代表に，病理診断が治療方針に直結することが多いので，適切な免疫染色・特殊染色の選択と運用がなされ，正確な病理診断がなされなければならない．このためには，病理医が疾患と免疫染色・特殊染色についての十分な知識を有していなければならないのは当然のことであるが，臨床医が免疫染色・特殊染色に対する理解と知識を有し，適切な部位より生検（手術材料の場合は切り出し）が行われ，鑑別診断を踏まえた的確な臨床情報の提供がなされることが重要である．

　The basic pathological diagnosis of gastrointestinal non-neoplastic diseases is determined by hematoxylin-eosin staining. What in some disease immunostaining or specific staining are extremely useful and indispensable. In this report, we describe immunostaining and specific staining in the pathological diagnosis of gastrointestinal non-neoplastic diseases and lesions, focusing on those in which the staining procedures are either highly useful or indispensable. In non-neoplastic diseases, such as infection, the pathological diagnosis is often associated with the treatment policy. Thus, appropriate immunostaining and specific staining must be used to facilitate an accurate pathological diagnosis. Moreover, pathologists must have adequate knowledge of diseases along with immunostaining and specific staining. However, it is essential for clinicians also to understand and have adequate knowledge about immunostaining and specific staining to conduct biopsies from an appropriate site（excision in the event of surgical materials）and provide accurate clinical information based on differential diagnosis.