大腸内視鏡検査における同時性多発腫瘍の頻度 The Prevalence of Synchronous Multiple Tumors between Adenoma, Intramucosal Cancer, and Invasive Cancer during Colonoscopy

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著者

    • 木村 聖路 KIMURA S.
    • 三戸町国民健康保険三戸中央病院内科 Division of Internal Medicine, Sannohe Municipal Hospital
    • 田中 正則 TANAKA M.
    • 弘前市立病院臨床検査科 Department of Pathology and Laboratory Medicine, Hirosaki City Hospital
    • 工藤 敏啓 KUDOH T.
    • 弘前大学大学院医学研究科消化器血液内科 Department of Gastroenterology and Hematology, Hirosaki University
    • 相沢 弘 AIZAWA H.
    • 弘前大学大学院医学研究科消化器血液内科 Department of Gastroenterology and Hematology, Hirosaki University
    • 福田 真作 FUKUDA S.
    • 弘前大学大学院医学研究科消化器血液内科 Department of Gastroenterology and Hematology, Hirosaki University

抄録

大腸腫瘍は同時性に併存する多発腫瘍の頻度が高い.今回腺腫,粘膜内癌,浸潤癌の各患者における同時性多発腫瘍の頻度を比較した.内視鏡検査で指摘した腺腫のみの患者476例(腺腫群),一つ以上粘膜内癌のある患者184例(粘膜内癌群),一つ以上浸潤癌のある患者179例(浸潤癌群)における単発腫瘍の頻度,多発腫瘍の場合はその種類と頻度を検討した.腺腫群は単発腺腫254例(53.4%),多発腺腫222例(46.6%)であり,多発腺腫の内訳は2病変144例(30.2%),3病変50例(10.5%),4病変以上28例(5.9%)だった.粘膜内癌群は単発粘膜内癌86例(46.7%),粘膜内癌と腺腫併存73例(39.7%),多発粘膜内癌25例(13.6%)だった.浸潤癌群は単発浸潤癌113例(63.1%),浸潤癌と腺腫併存36例(20.1%),浸潤癌と粘膜内癌併存19例(10.6%),多発浸潤癌11例(6.2%)だった.多発腫瘍の頻度は粘膜内癌のある患者で最も高く,次に腺腫のみの患者であり,浸潤癌のある患者で最も低かった.統計学的には腺腫群と浸潤癌群(p<0.05),粘膜内癌群と浸潤癌群(p<0.005)で有意差を認めた.内視鏡検査における大腸腫瘍は腺腫,粘膜内癌などの粘膜内病変は同時性多発腫瘍を併存しやすく,浸潤癌はむしろ単発腫瘍として指摘されやすい.<br>

Multiplicity is one of the important biological behaviors of colorectal tumors. Synchronous coexistence of adenomas and/or carcinomas in one individual is commonplace, and is frequently detected by colonoscopy. This study aimed to compare the prevalence of solitary and synchronous multiple tumors between adenoma, intramucosal cancer, and invasive cancer. The study included 476 patients in whom only adenomas were detected (group A), 184 patients in whom at least one intramucosal cancer was detected (group B), and 179 patients in whom at least one invasive cancer was detected (group C), all of whom underwent colonoscopy and subsequent endoscopic or surgical resection. The prevalences of a solitary tumor and those of multiple tumors between the three groups were statistically analyzed. Among patients in group A, 254 (53.4%) had a solitary adenoma, and 222 (46.6%) had multiple adenomas consisting of 144 (30.2%) with double, 50 (10.5%) with triple, and 28 (5.9%) with four or more adenomas. Among patients in group B, 86 (46.7%) had a solitary intramucosal cancer, 73 (39.7%) had an intramucosal cancer with adenoma (s), and 25 (13.6%) had multiple intramucosal cancers. Among patients in group C, 113 (63.1%) had a solitary invasive cancer, 55 (30.7%) had an invasive cancer with adenoma (s) and/or intramucosal cancer (s), and 11 (6.2%) had multiple invasive cancers. Patients in group B showed highest prevalence of synchronous coexisting lesions, followed by those in group A, and those in group C showed lowest prevalence. Statistical significance was observed between group A and C (p<0.05), and group B and C (p<0.005). In the colorectum synchronous multiple tumors occurred more frequently in patients with adenoma and/or intramucosal cancer, while patients with invasive cancer were diagnosed more frequently as having a solitary tumor.<br>

収録刊行物

  • 日本大腸肛門病学会雑誌  

    日本大腸肛門病学会雑誌 61(5), 240-246, 2008-05-01 

    The Japan Society of Coloproctology

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各種コード

  • NII論文ID(NAID)
    10021941431
  • NII書誌ID(NCID)
    AN00195100
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    00471801
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
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