内視鏡検診の現状と課題─経鼻内視鏡検診の現状と課題

Current Status and Issues of Transnasal Endoscopic Screening for Gastric Cancer

要旨●胃がん内視鏡検診において，経鼻内視鏡検査は良好な受容性により任意型検診，対策型検診とも増加傾向にある．ただし検診として多数例を検査するためには，効率のよい前処置の工夫など検査までの時間短縮が必要である．近年，経鼻内視鏡の仕様は経口内視鏡と同等に近づきつつあり，胃がん検診成績も経口内視鏡同様良好であるが，経鼻内視鏡検診における偽陰性を減らすためには，経鼻内視鏡の特性を考慮した丁寧な近接観察や連続性のある記録，ダブルチェック，画像カンファレンスなどの精度管理が必要である．今後は，胃がん検診受診率向上のためにも内視鏡検診に積極的に経鼻内視鏡を導入すべきと考えられる．

　In the field of endoscopic screening for gastric cancer, transnasal endoscopy is becoming increasingly popular among opportunistic and population-based screening methods because of good acceptability. However, to be able to examine a larger number of patients, it is necessary to decrease the overall testing time by carrying out pretreatment efficiently. In recent years, the specifications of transnasal endoscopes are becoming increasingly similar to oral endoscopes；the rates of gastric cancer detection by transnasal endoscopy are as good as those by oral endoscopy. Accuracy control（ex；polite close observation and continuous record, double checks and image review conference）is required in order to reduce false negative ratio in transnasal endoscopy.

　In future, transnasal endoscopy should be actively introduced in mass screening to increase the percentage of examinees.