中・下咽頭・喉頭病変の拡大内視鏡像

Endoscopic Feature of Superficial Lesion of Nasopharynx, Hypopharynx, and Larynx

要旨●上部消化管スクリーニング検査時に，咽頭・喉頭領域を観察することの重要性が広く認知されるようになり，内視鏡医がこれらの領域の病変を発見する機会も増加している．観察時にヨード撒布のできない咽頭・喉頭では，NBIをはじめとする画像強調機能を有する拡大内視鏡が現時点で最も優れた観察ツールであり，病変の拾い上げから質的診断まで可能である．咽頭癌・喉頭癌の多くは食道と同じ扁平上皮癌であり，腫瘍・非腫瘍の鑑別には食道癌の診断学を適応可能であると考えるが，拡大内視鏡検査による血管分類を用いた深達度診断の有用性については，より多数例での検討が必要だと考えられた．

　The importance of observing pharynx and larynx during the upper endoscopy has now become widely known, and the lesions of these areas, as detected by gastrointestinal endoscopists, are increasing. Although we cannot use iodine solution in the pharynx and larynx, IEE（image enhanced endoscopy）, such as narrow band imaging, plays an important role for detection of superficial lesions. With IEE, we can detect small lesions and diagnose whether they are benign or malignant. Most of the cancers of pharynx and larynx are derived from squamous cells. Thus, we can apply the diagnosis of esophageal cancer for differential diagnosis of laryngo-pharyngeal Ca. However, currently, the endoscopic estimation of the depth of invasion with magnified endoscopy remains difficult. Further research with many cases in this regard is needed.