食道腫瘍の内視鏡治療後サーベイランス：Barrett食道腺癌

Surveillance Following Endoscopic Resection of Barrett's Esophageal Adenocarcinoma

要旨●本邦でも欧米と同様にBarrett食道腺癌の頻度は増加傾向であり，今後もBarrett食道腺癌に対する内視鏡治療は増加することが予想される．本邦と欧米では，Barrett食道腺癌内視鏡治療後の方針は大きく異なる．欧米では残存Barrett粘膜に対する内視鏡的焼灼術が施行されるが，本邦のガイドラインではBarrett食道そのものに対して発癌予防目的に内視鏡治療を行うことは推奨されていない．また，Barrett食道腺癌の内視鏡治療後サーベイランスについては，必要性，方法，検査間隔など，定まっていない部分も多い．本稿ではBarrett食道腺癌の内視鏡治療後のサーベイランスについて，本邦と欧米それぞれの最新のガイドラインも含めて解説した．

　Although squamous cell carcinoma remains the predominant esophageal cancer type in Japan, the rate of Barrett's esophageal adenocarcinoma is increasing, with an expected increase in the number of patients undergoing endoscopic treatments. Postendoscopic treatment policies for Barrett's esophageal adenocarcinoma significantly differ in Japan and Western countries. While endoscopic ablation of the residual Barrett's mucosa is performed in Western countries, Japanese guidelines do not recommend endoscopic treatment of Barrett's esophagus for cancer prevention. Additionally, various aspects of surveillance following endoscopic treatment for Barrett's esophageal adenocarcinoma, such as the necessity, methods, and intervals, remain undefined. This article discusses surveillance approaches following endoscopic treatment of Barrett's esophageal adenocarcinoma, including the latest guidelines in Japan and Western countries.