表在型Barrett食道腺癌内視鏡的切除術後の長期予後—SSBEを中心に

Long-term Outcomes after Endoscopic Resection for Superficial Barrett's Esophageal Adenocarcinoma Derived from Short-segment Barrett's Esophagus

要旨●表在型Barrett食道腺癌に対する内視鏡的切除術後の転移リスク，長期予後については不明な点が多く，今回当院においてshort segment Barrett's esophagusに発生した表在型Barrett食道腺癌57例をもとに内視鏡的切除術後の経過について検討した．深達度pLPM以浅かつ脈管侵襲陰性，および純粋分化で深達度pDMMかつ脈管侵襲陰性であれば転移はなく長期予後は良好であった．また，従来は追加治療の対象と考えられてきたpSMであっても，“深達度SM 1〜500μm”，“腫瘍径30mm未満”，“脈管侵襲陰性”，“DMM以深に低分化癌成分がない”のすべてを満たす症例であれば転移を認めず良好な予後が得られ，今後内視鏡的治癒切除の定義を拡大できる可能性が示唆された．

　There is yet no clear information regarding the risk of metastasis after endoscopic resection for superficial Barrett's esophageal adenocarcinoma. In this study, we investigated the long-term outcomes after endoscopic resection for 57 cases of superficial Barrett's esophageal adenocarcinoma derived from short-segment Barrett's esophagus. Lesions of pLPM without lymphovascular involvement and pDMM without a poorly differentiated component and lymphovascular involvement exhibited no metastasis and had favorable prognosis. SM cancers（≤500μm）without a poorly differentiated component, lymphovascular involvement, and ≤30mm also did not exhibit metastasis. Therefore, there is a possibility to expand the definition of endoscopic curative resection in the future.