超拡大内視鏡（Endocytoscopy system）による咽頭癌診断

Diagnostic Ability of Endocytoscopy for Superficial Pharyngeal Cancers

要旨●咽頭表在癌はESD（endoscopic submucosal dissection）やELPS（endoscopic laryngopharyngeal surgery）などの低侵襲治療を行うことで患者のQOLを維持することが可能であり，早期発見が望まれる．しかし，咽喉頭は狭く，複雑な構造に加え，咽頭反射が出現しやすいため，内視鏡観察が困難な部位である．また，病変部位や大きさによっては喉頭展開を行わないと病変が認識できないものも存在する．超拡大内視鏡を使用すると，術前に指摘困難であった病変に対しても，切除範囲や切除の必要性について正確な評価が可能になると考えられる．

　Minimally invasive treatments, such as endoscopic submucosal dissection and endoscopic laryngopharyngeal surgery, maintain the quality of life of patients with superficial pharyngeal cancers ; hence, early detection of such cancer is desirable. However, endoscopic observation is difficult because of the complicated structure of the pharynx and the presence of the pharyngeal reflex. A qualified biopsy may be difficult and the lesion may not be recognizable without laryngeal expansion depending on its location and size. The use of endocytoscopy will allow an accurate assessment of the extent and necessity of lesion resections that are difficult to identify preoperatively.