Clinical Estimation of Mucosal Cancer of the Esophagus by Endoscopic Staining.
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概要
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Recent advances in esophageal cancer clinics in Japan include the early detection and treatment of esophageal mucosal cancer. Endoscopic staining techniques have made possible the early detection of mucosal cancers and their eradication using endoscopic mucosal resection techniques (EMR) with minimal invasion, thus preserving the esophagus. The iodine staining technique is the most sensitive in detection of mucosal cancer, for it can differentiate abnormal mucosa as a yellowish white "unstained area" against a dark brown normal mucosa. The number, size and distribution of mucosal cancers can also be identified with ease. EMR can be employed as a radical treatment for mucosal cancers confined to the lamina propria mucosae, which seldom have lymph node metastasis. Ten-year-survival curves of our patients with mucosal cancer of the esophagus treated by esophagectomy and that by EMR showed no significant difference. Clinical estimation of the depth of a cancer invasion into the esophageal wall was essential for the precise indication of EMR. Endoscopy aided by toluidin blue-iodine double staining was most useful for this estimation, and its accuracy rate was 96%. In the case of type IIc lesions (slightly depressed type), which is most frequent among mucosal cancers of the esophagus, the area unstained by toluidine blue can be observed when the lesion is confined to the epithelium layer. Blue stained dots, or reticulum, in a unstained area strongly suggests cancer infiltration into the lamina propria mucosae.
- 特定非営利活動法人 日本気管食道科学会の論文
特定非営利活動法人 日本気管食道科学会 | 論文
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