原発性小腸癌の臨床病理学的特徴—内視鏡診断を中心に

Clinicopathological Features and Endoscopic Diagnosis of Primary Small-bowel Cancer

要旨●原発性小腸癌は比較的まれであるが，カプセル内視鏡およびバルーン内視鏡の普及に伴いその診断機会は増加している．原発性小腸癌はさまざまな肉眼形態を呈し，他の小腸腫瘍との鑑別が重要である．カプセル内視鏡やバルーン内視鏡のみならず，従来の体外式超音波検査，小腸X線造影検査，造影CT検査など他の診断法と組み合わせながら効率よく検査，診断を進めていく必要がある．しかし，原発性小腸癌はいまだ他臓器転移や腹膜播種を伴った進行期の状態で発見されることが多く，今後さらなる早期診断法の確立ならびに病態の解明が必要である．

　Primary small-bowel cancer is relatively uncommon, but the incidence of the disease has increased with the widespread use of capsule and balloon endoscopy. Primary small-bowel cancer exhibits varied morphologies, and it is important to differentiate it from other small-bowel tumors. Other diagnostic modalities, such as conventional external ultrasonography, small-bowel radiography, and contrast-enhanced computed tomography, should be used in addition to capsule endoscopy and balloon endoscopy for efficient diagnosis. However, primary small-bowel cancer is often detected at an advanced stage, with metastasis to other organs or peritoneal dissemination. Further issues to be addressed include the establishment of an early diagnostic method and the elucidation of the disease pathogenesis.