1. 上部消化管に対するendo-cytoscopy systemの現況

Endo-cytoscopy System for Upper Gastrointestinal Tract

要旨　endo-cytoscopy systemは450倍，1,125倍の拡大能を有する軟性鏡で生体染色することでリアルタイムに粘膜表層の細胞を観察することができる．本稿では食道，胃のendo-cytoscopy systemでの観察の現状について報告し，さらに現在開発中の一体型endo-cytoscopyについて紹介する．実際の観察では生体染色にメチレンブルーを使用する．正常重層扁平上皮のN/C比が低く，核の染色性，大きさの同等なのに比べ，癌部では細胞密度の増加，核の染色性，大きさの不揃いな核異型が観察された．胃癌の観察では不規則な腺窩構造，細胞配列の極性の乱れ，核の多形性が観察され良悪性の鑑別に有用であると思われる．

　The endo-cytoscopy system consists of two flexible endoscopes whose magnifying capability is 450× and 1,125×. We can observe the cells existing on the mucosal surface at real time using vital staining such as methylene blue.

　In this article, we report details of the observation of the esophagus and stomach. Further we introduce the newly developed "integrated type endocytoscopy".

　By observing the normal esophageal mucosa using the endo-cytoscopy system and methylene blue staining, we were able to visualize the cells existing on the surface of the squamous epithelium. These cells were arranged homogenous and the nucleus-cytoplasmic ratio was uniform and low. In the observation of esophageal cancer, the density of the cell increased extremely compared with the normal squamous epithelium. The cell distribution was irregular with extreme heterogeneity of the cells with nuclei of different staining, size and shape. The nucleus- cytoplasm ratio was very irregular.

　In the observation of gastric cancer, irregular and branched tubules, loss of polarity and plemorphism of the nuclei can be observed.