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Stomach and Intestine(Tokyo) Volume 58, Issue 8 （August 2023）

胃と腸 58巻8号（2023年8月発行）

Japanese English

今月の主題十二指腸拡大内視鏡の最新知見

主題

非乳頭部十二指腸腺腫・癌の拡大内視鏡診断—自施設での考え方 Association between Mucin Phenotype, Helicobacter pylori Infection, and Magnifying Endoscopic Findings of Superficial Non-ampullary Duodenal Epithelial Tumors 郷田憲一 ¹ , 阿部圭一朗 ¹ , 近藤真之 ¹ , 金森瑛 ¹ , 吉永智則 ¹ , 石川学 ¹ , 山口真太朗 ¹ , 久野木康仁 ¹ , 菅谷武史 ¹ , 富永圭一 ¹ , 鈴木統裕 ¹ , 漆原史彦 ¹ , 石田和之 ² , 増山仁徳 ³ , 長崎秀彰 ⁴ , 入澤篤志 ¹ Kenichi Goda ¹ , Keiichiro Abe ¹ , Masayuki Kondo ¹ , Akira Kanamori ¹ , Tomonori Yosinaga ¹ , Manabu Ishikawa ¹ , Shintaro Yamaguchi ¹ , Yasuhito Kunogi ¹ , Takeshi Sugaya ¹ , Keiichi Tominaga ¹ , Tsunehiro Suzuki ¹ , Fumihiko Urushibara ¹ , Kazuyuki Ishida ² , Hironori Masuyama ³ , Hideaki Nagasaki ⁴ , Atsushi Irisawa ¹ ¹獨協医科大学内科学（消化器）講座 ²獨協医科大学病理診断科 ³増山胃腸科クリニック ⁴長崎病院外科・消化器科 ¹Department of Gastroenterology, Dokkyo Medical University, Tochigi, Japan ²Department of Diagnostic Pathology, Dokkyo Medical University, Tochigi, Japan ³Masuyama Gastroenterology Clinic, Ohtawara, Japan ⁴Department of Surgery and Gastroenterology, Nagasaki Hospital, Ashikaga, Japan キーワード：十二指腸 , 非乳頭部 , 腺腫 , 腺癌 , 内視鏡診断 Keyword: 十二指腸 , 非乳頭部 , 腺腫 , 腺癌 , 内視鏡診断 pp.1010-1023

発行日 2023年8月25日 Published Date 2023/8/25

DOI https://doi.org/10.11477/mf.1403203296

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要旨●最近，本邦における非乳頭部十二指腸癌の罹患率が欧米に比し高いことが判明した．実際に本邦における日常臨床で表在性非乳頭部十二指腸上皮性腫瘍（SNADET）に遭遇する機会は急速に増加している．近年，胃・十二指腸上皮性腫瘍の粘液形質が免疫組織化学的に解析可能となり，粘液形質に基づいたSNADETの臨床病理学的特徴が徐々に明らかとなってきた．粘液形質およびHelicobacter pylori感染状態と，拡大内視鏡所見を含めたSNADETの臨床病理像との関連性について探索的に検討した結果も踏まえ，現時点での筆者らの見解を述べたい．

　Recent studies revealed a higher prevalence of non-papillary duodenal cancer in Japan than in Western countries. The chances of encountering SNADET（superficial non-papillary duodenal epithelial tumors）in practical endoscopy in Japan are rapidly increasing. Recently, the immunohistochemical analysis of mucin phenotypes of gastroduodenal epithelial tumors has become possible, and the clinicopathological characteristics of SNADET based on mucin phenotypes have been clarified gradually. However, studies demonstrating the relationships between the clinicopathological characteristics and magnifying endoscopic findings of SNADET are limited. Therefore, this exploratory study was conducted to investigate the association between clinicopathological findings, including magnifying endoscopy of SNADET, and not only the mucin phenotypes but also Helicobacter pylori infection status in the patients. We stated our perspectives about these associations based on the study results and suggested an effective process of the endoscopic diagnosis of SNADET.