食道腫瘍の内視鏡治療後サーベイランス：扁平上皮癌—リスク因子を考慮したサーベイランスの重要性

The Importance of Surveillance Following Endoscopic Resection for Esophageal Squamous Cell Carcinoma Based on the Risk Factors

要旨●食道扁平上皮癌の内視鏡治療後には，異時性食道内多発癌の他にも，二次原発悪性腫瘍が高頻度に発生する．禁酒・禁煙によって明らかに異時性食道癌と二次原発悪性腫瘍が減少したため，内視鏡治療後に禁酒・禁煙の指導を繰り返し行うことは非常に重要である．ヨード多発不染帯，食道癌リスク検診問診票，アルコール使用障害特定テスト，平均赤血球容積，軟口蓋粘膜のメラノーシスは，食道扁平上皮癌のリスク因子である．これらのリスク因子を考慮し，二次原発悪性腫瘍も加味したサーベイランス検査を行う必要がある．

　Patients who have undergone endoscopic resection of esophageal squamous cell carcinoma may develop synchronous or metachronous multiple esophageal cancers and secondary primary malignant tumors. Abstinence from drinking alcohol and smoking significantly decreased the risk of developing subsequent esophageal metachronous cancer and secondary primary tumors. Guidance on abstaining from drinking and smoking is crucial. Factors such as Multiple Lugol-voiding lesions, Health risk appraisal model for predicting the risk of esophageal squamous cell carcinoma based on their alcohol flushing, Alcohol use disorders identification test, Mean corpuscular volume, and Soft palatal melanosis are with the risk of esophageal squamous cell carcinoma. Based on these risks, surveillance following endoscopic submucosal dissection is important.