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要旨●pit pattern診断の歴史を簡単に概説し,その基本とNBI拡大内視鏡所見との関係について当科のデータを示し考察を加えた.JNET分類とpit patternの対応関係を大腸の過形成/SSP,腺腫,早期癌を対象にして検討した結果,整なsurface patternを呈する病変(JNET分類Type 1,Type 2A)ではNBI拡大内視鏡所見とpit pattern診断はほぼ一致していた.不整なsurface pattern(JNET分類 Type 2B,Type 3)を呈する病変では約3割でNBI拡大観察のsurface patternがpit patternよりも不整に見える傾向があった.NBI拡大観察におけるsurface pattern(pit様構造)と色素を用いたpit pattern所見には相違があり,個々の病理組織背景と診断特性を理解したうえで日常診療において使い分けることが重要である.
This chapter introduces a history of pit pattern diagnosis and its basic rule. In addition, it describes the correlation between pit pattern diagnosis and magnifying NBI findings with some data of our clinical research. We evaluated the correlation between pit pattern and JNET classification using consecutive colorectal tumors comprising hyperplastic polyp, sessile serrated polyp, adenoma, and early cancer. NBI findings(pit-like pattern)nearly corresponded to pit pattern in lesions with regular surface pattern(JNET Type 1, 2A). Conversely, NBI findings(pit-like pattern)and pit pattern were not always the same in lesions with irregular surface pattern(JNET Type 2B, 3). In such case, NBI appearance tends to be more irregular than pit pattern. A difference certainly exists between surface pattern(pit-like pattern)in NBI and real pit pattern. Hence, it is essential to be familiar with each histopathological characteristic and diagnostic feature to use them most effectively in daily colonoscopy.
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