生検組織診断Group 2におけるNBI併用拡大内視鏡の生検前診断

Pre-biopsy Diagnosis Using Magnifying Narrow Band Imaging for Group 2 Gastric Lesions Diagnosed from Biopsy Specimens

要旨●胃癌取扱い規約第14版における生検組織診断Group 2には癌から再生異型までの病変が含まれる．生検組織診断Group 2と診断された場合には再検査が臨床対応の基本であるが，再検査前に内視鏡画像の見直し，深切りや免疫染色を含む生検検体の見直し，および内視鏡医と病理医の対話を行うという慎重かつ柔軟な対応が必要である．さらに，本検討での生検組織診断Group 2病変におけるNBI併用拡大内視鏡の生検前診断能を鑑みると，時には診断的治療としてのESDは臨床対応の一つとして許容される．

　According to the 14th edition of the Japanese Classification of Gastric Carcinoma, a Group 2 biopsy diagnosis is defined as indefinite for neoplasia, including regenerative atypia, adenoma, and carcinoma. Endoscopic reexaminations are therefore necessary for the diagnosis of Group 2 gastric lesions, prior to which it is necessary to review endoscopic images and biopsy specimens, including deep cutting and immunostaining. Such reviews must be accompanied with careful discussion between endoscopists and pathologists. Furthermore, considering the pre-biopsy diagnosis using magnifying narrow band imaging for Group 2 gastric lesions in this study, ESD as a diagnostic treatment is acceptable as one of first clinical support for the gastric lesions.