予後不良な早期消化管癌の病理組織学的特徴—食道癌

Histopathological Features of Poor-prognostic Early Esophageal Cancer

要旨●食道表在癌すなわち食道T1癌は近年，積極的に内視鏡的切除が行われるようになった．「食道癌診療ガイドライン」ならびに2020年に策定された「食道癌に対するESD/EMRガイドライン」，また諸家の報告から，内視鏡的切除標本の病理組織学的診断において追加治療の観点から重要な病理組織学的所見が明らかとなった．すなわち，癌の組織型，深達度，脈管侵襲の有無，浸潤様式は内視鏡的切除後の追加治療の重要な観察項目であり，病理医は上記項目について十分注意して正確に診断する必要がある．

　Recently, endoscopic resection is frequently performed for superficial esophagus cancer or esophageal T1 cancer. Accurate and detailed endoscopic resection specimens' pathological diagnosis became crucial for esophageal T1 cancer, because the diagnosis determines whether additional treatment is necessary or not after endoscopic resection, which is regulated by the Guideline for Diagnosis and Treatment of Carcinoma of the Esophagus（2017）and ESD/EMR Guidelines for Esophageal Cancer devised in 2020. The depth of tumor invasion（pT）, presence or absence of vessel permeation（ly/v）, and INF（infiltrative growth pattern）are the most important diagnostic items for additional treatment after the procedure. Pathologists should carefully diagnose these items, especially in esophageal T1 cancer.