早期胃癌範囲診断の検証に必要な内視鏡画像と病理組織像の対比

Method for Facilitating Correspondence between Endoscopic and Histological Images to Verify Endoscopic Diagnosis

要旨●正確な内視鏡診断を行ううえで，病理組織像を内視鏡画像に還元することは重要なことである．特に画像強調内視鏡や拡大内視鏡の普及により，内視鏡画像はより組織構築を反映したものになっており，病理組織像との対比も腺管レベルの詳細なものが求められている．そこで筆者らは，内視鏡画像と病理組織像を体系的に対比する方法をKOTO methodとして提唱し，報告した．対比方法は，以下の3段階で行う．①検体の固定と画像撮影，②検体画像と病理組織像の重ね合わせ，③検体画像と内視鏡画像の対応および内視鏡画像と病理組織像の重ね合わせ．この方法の詳細を具体例の提示を含め，説明する．体系的な対比が内視鏡診断の進歩につながることを期待する．

　To establish an accurate diagnosis following endoscopy, histological information needs to correspond with endoscopic images. Because image-enhanced and magnifying endoscopy provides detailed images reflecting histological structures, more precise correspondence between endoscopic and histological images at a gland level is desired. Therefore, we present a systematic one-to-one method, known as the KOTO method, to facilitate correspondence between endoscopic and histological images. This method comprises three steps：fixation and acquiring images of endoscopically resected materials, matching the obtained images with histological images, and fitting the histological images to those obtained from endoscopically resected materials. We also present a representative case that utilized this method. This precise method for facilitating correspondence will help establish a more accurate endoscopic diagnosis.