食道表在癌のEUS診断

Current Status and Theme：Prediction of the Invasion Depth of Superficial Squamous Cell Carcinoma by Endoscopic Ultrasonography

要旨●超音波内視鏡（EUS）は，深達度診断やリンパ節転移診断など，食道癌診療のさまざまな場面で使用されている．深達度診断には主に細径プローブが用いられ，内視鏡による通常観察や拡大観察に比べてやや高い診断精度が報告されているが，EUSを加えた際の上乗せ効果がどの程度かはあまり検討されていない．しかし，通常観察と拡大観察で粘膜筋板以深への浸潤癌と診断される病変は，通常観察と拡大観察だけでの診断精度は十分でなく，EUSを加える意義はあると考えている．今後はより信頼性の高い研究で，EUSの診断精度や上乗せ効果を明らかにする必要がある．

　EUS（endoscopic ultrasonography）has been used to diagnose SESCC（superficial esophageal squamous cell carcinoma）invasion depth and lymph node metastasis. A miniature probe is used to diagnose the depth of the tumor invasion. The diagnostic accuracy of EUS is higher than that of white-light imaging（WLI）and magnifying endoscopy with narrow-band imaging（ME-NBI）. However, the additional benefit of WLI and ME-NBI is unclear. Currently, the diagnostic accuracy of tumor invasion depth for SESCC-suspected muscularis mucosa invasion by WLI and ME-NBI is not sufficient. Therefore, we predict that EUS is a meaning modality followed by WLI and ME-NI. Future multicenter studies are needed to determine the diagnostic accuracy of EUS and additional benefit of EUS to WLI and ME-NBI.