大腸T1癌内視鏡的切除検体の正しい取り扱いと病理診断—内視鏡的切除標本の病理診断の基本とピットフォール

Correct Handling and Histopathological Diagnosis of Endoscopically Resected Colorectal T1 Cancer: The Basics and Pitfalls of the Pathological Diagnosis of Endoscopically Resected Specimens

要旨●内視鏡的切除検体の正しい病理診断には，正確な評価可能な組織切片が作製されなければならない．そのためには，切除検体の取り扱いが適切になされる必要がある．検体の取り扱いは，検体の貼り付け，固定，画像撮影，切り出し，割を入れた検体の画像撮影，標本作製の順に行われ，これらが適切に行われて初めて病理診断（重要な病理組織学的所見の判定）が可能となる．特に内視鏡像で浸潤が疑われ最深部と予想される部位が，組織切片で観察されるような切り出しを行う必要がある．そして，内視鏡診断精度の向上のためには，病理診断後はマッピング図と内視鏡像の対比による内視鏡所見の再評価が必要である．

　For correct histopathological diagnosis of endoscopically resected specimens, accurate and evaluable histological sections must be prepared. Therefore, proper handling of the resected tissue is necessary. Specimens are handled in the following order：pasting, fixing, photography, cutting, taking a photograph of the split sample, and preparing the sample. A pathological diagnosis（determination of important histological findings）is performed only when the specimens are properly handled. In particular, it is essential to cut the specimen at the deepest invasive area as suggested by the endoscopic image.

　Furthermore, in order to improve the accuracy of the endoscopic diagnosis, re-evaluating the endoscopic findings by comparing the mapping diagram and the endoscopic image after the pathological diagnosis is necessary.