頭頸部癌に重複した食道表在癌の臨床像とその病理像―食道色素研究会アンケート調査の報告

Clinical Characteristics and Pathological Findings in Superficial Esophageal Cancer Associated with Head and Neck Cancer (Report of Questionnaires from the Japanese Research Society for Early Esophageal Cancer and Chromoendoscopy)

　頭頸部癌患者3,000人に色素内視鏡を行い8.7％に食道癌が発見された．重複癌317例で同時性60.9％，異時性頭頸部癌先行28.1％，異時性食道癌先行10.1％であった．頭頸部癌の占居部位は下咽頭41.9％と最も多かった．喫煙率は77.6％，Brinkmann index1053.0，飲酒率は83.0％，Sake index104.1であった．肉眼型では0-IIc47.3％，0-IIb20.5％，長径では11～20mmが30.7％と最も多く，深達度ではm1，m2が49.1％を占めた．食道不染帯の数はまだら食道が29.3％と最も多く，食道多発癌は32.8％に認めた．治療方法ではm1，m2の58.7％にEMRが施行され，m3，sm1の54.8％，sm2，sm3の76.6％に手術が施行された．また全体の12.0％に放射線・化学療法が施行されていた．

　Three thousand patients with head and neck cancer underwent endoscopic screening with iodine staining and esophageal cancer was detected in 8.7 ％ of these patients. The number of patients with double cancer was 317 cases, which consisted of 60.9 ％ synchronously, 28.1 ％ metachronously with detection of head and neck as the primary cancer, and 10.1 ％ with esophageal cancer as the primary one. The largest location of head and neck cancer was the hypopharynx. The rate of smoking was 77.6 ％ and the Brinkmann index was 1053.0. In addition, the rate of drinking was 83.0 ％ and the Sake index was 104.1. Regarding the type of macroscopic appearance, 0-IIc was found in 47.3 ％ and 0-IIb in 20.5 ％. The largest diameter of tumor was 11～20 mm in 30.7 ％ and the depth of wall invasion of “m1 and m2” occupied 49.1 ％. Regarding the number of unstained areas, the so-called “multiple small iodine unstained lesions” type was largest in 29.3 ％, and multiple esophageal cancer was found in 32.8 ％. For treatment, 58.7 ％ of patients with “m1 and m2” underwent EMR, but, 54.8 ％ with “m3 and sm1” and 76.6 ％ with “sm2 and sm3” underwent surgical operation. Finally, radiation and/or chemotherapy was performed in 12.0 ％ of all patients.