臨床医の考える臨床画像と病理所見の対比—胃・十二指腸

“Deep Pairing” of Clinical and Pathological Findings of Gastric and Duodenal Tumors：A Collaborative Work by Clinicians and Pathologists

要旨●臨床医と病理医は，ともに適切な治療による患者の利益を目標としなくてはならない．画像診断は消化管病変の性質を正確に把握するために重要であり，内視鏡検査やX線造影検査などの臨床画像所見と病理組織学的所見との整合性を確認することでのみ，その精度を向上させることが可能となる．対比を通じて診断能力を向上させるためには，病理医との適切な連携が必要であり，対応する設備拡充や技術の向上も求められる時代となった．特に拡大内視鏡診断が普及した現在，“高い解像度を目指した”胃・十二指腸腫瘍性病変の診断と治療，病理医の負担に配慮した検体の取り扱いとコミュニケーション，病理組織学的所見との対比について，自施設の経験と取り組みを供覧する．

　Clinicians and pathologists must collaborate to ensure patients benefit from appropriate treatment. Diagnostic imaging is important for understanding the nature of gastrointestinal lesions, and its accuracy can be further enhanced by confirming the consistency of the findings obtained through clinical imaging techniques such as endoscopy and X-ray contrast with pathological findings. To improve diagnostic ability, appropriate cooperation with pathologists is required. It is also necessary to upgrade the corresponding equipment and improve endoscopic techniques. In particular, now that magnifying endoscopic diagnosis has become popular and important, there is a need for the diagnosis and treatment of gastric and duodenal neoplastic lesions that are capable for the era of magnifying endoscopy. We hereby show the experience of our facilities in the handling of resected specimens, communication with pathologists, and the “deep pairing” of clinical image findings with pathological findings.