癌併存大腸SSLの内視鏡診断—通常内視鏡の立場から

Conventional Endoscopic Findings of Colorectal Sessile Serrated Lesions with Cancer

要旨●過去13年間に当科および関連施設にて診断された癌併存大腸SSL 17例を対象とし，病理組織学的所見と対比可能であったSSLと癌の領域の内視鏡所見を遡及的に比較検討した．その結果，癌領域はSSL領域に比べ，発赤（癌領域64.7%/SSL領域0%，p<0.05），結節・顆粒状隆起（癌領域64.7%/SSL領域5.9%，p<0.05）が多くみられた．一方でSSL領域の色調は全例で同色調，ないし褪色調を呈した（癌領域35.3%/SSL領域100%，p<0.05）．以上より発赤，結節・顆粒状隆起の存在が癌併存SSLにおける癌領域の特徴的な所見であり，癌併存大腸SSLは通常内視鏡で診断できる可能性が示唆された．

　Aim：The purpose of this study was to compare the endoscopic findings between the cancerous area and the SSL（sessile serrated lesion）in SSL with cancer.

　Method：From 2008 to 2021, we retrospectively reviewed colonoscopy records at our institutions and identified cases of endoscopically or surgically resected colorectal SSLs with cancer. The colonoscopic findings of the cancer area in SSL with cancer were compared with those of the area of SSL.

　Results：In 17 patients, there were 17 SSLs with cancer. Cancer areas had a reddish appearance and protruding morphology with a nodular or granular surface more frequently than SSL（p<0.05）.

　Conclusion：Areas of cancer in SSL may have conventional colonoscopic features that differ from those of SSL.