内視鏡がX線に期待するもの―胃

What Endoscopist Expects Radiologist in Stomach Examination？

　早期胃癌の診断において，X線検査と内視鏡検査は長らく車の両輪にたとえられ，お互いに切磋琢磨しながら今日に至っている^1)～4)．

　内視鏡検査とX線検査との関連を見ると，日常診療の場では急性出血など特別の場合を除けば，まずX線検査が行われ，食道，胃，十二指腸の異常がチェックされ，その所見を参考にしながら，第2段階として胃の内視鏡検査を行うのが普通のやり方で，胃の内視鏡検査には精密検査としての役割が重視されてきた．

　Inspite of recent development of X-ray and endoscopic technique, it is still a difficult problem to detect small gastric cancer like less than 5 mm in size or its flat type like typical Ⅱb, but this is rather prospective in endoscopic field.

　In case of advanced gastric cancer, endoscopy is impotent in diagnosing the range of submucosal spreading, or involvement of the adjacent organ, which are expected to resolve in X-ray side.

　Insufficient points of reoperative gastroscopic examination were reviewed with brief description of recent development of endoscopy and expectation to X-ray by presenting 3 instructive cases.

　In addition, how endoscopic examination should be for the purpose of checking up the suspicious lesion of cancer was described with the expecting matters to X-ray examination for the purpose, and pointed out the problem of todays mass screening method by reviewing the data.