초단분절 바렛식도에서 발생한 식도 선암의 내시경 점막하 박리술 1예
A Case of Endoscopic Submucosal Dissection for Esophageal Adenocarcinoma Arising from Ultrashort-Segment Barrett’s Esophagus
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초록
바렛 식도는 위식도 접합부위의 편평 상피 세포가 원주 상피 세포로 이행된 부위를 일컬으며 최근 증가하고 있는 식도 선암의 주요 원인이다. 바렛 식도는 편평 원주 상피 접합부가 위식도 접합부 상방으로 3 cm 이상 상승된 장분절 바렛 식도와 3 cm 미만으로 상승된 단분절 바렛 식도로 분류한다. 장분절 바렛 식도에서 악성변화가 더 빈번하나 바렛 식도의 길이에 관계없이 선암의 발생이 가능하다. 최근 조기에 진단되어 점막에 국한된 식도 선암에 대해 내시경적 치료를 통한 좋은 결과를 얻고 있다. 내시경 치료 중 점막하 박리술을 통해 국소 재발을 보다 효과적으로 낮추고 종양의 완전 절제가 가능하게 되었다. 저자들은 바렛 식도 중에서도 초단분절 바렛 식도에서 기원한 식도 선암을 내시경 점막하 박리술을 통해 성공적으로 치료한 증례를 경험하여 문헌 고찰과 함께 보고한다.
Abstract
Barrett’s esophagus is defined as the replacement of normal squamous epithelium of distal esophagus with specialized columnar epithelium. This condition is considered to be a premalignant lesion of esophageal adenocarcinoma. Barrett’s esophagus is classified into long-segment (≥3 cm in length) and short-segment (＜3 cm in length). Detection of the former is more difficult. Adenocarcinomas arising from short-segment Barrett’s esophagus are uncommon in Korea. Barrett’s adenocarcinoma restricted to the mucosa can be treated by endoscopic mucosectomy. In recent years, endoscopic submucosal dissection for early esophageal cancer has been extensively applied because it is a reliable method to achieve en bloc resection. In this paper, we report a case of esophageal adenocarcinoma arising from ultrashort-segment Barrett’s esophagus, which was successfully resected by endoscopic submucosal dissection.
참고문헌 (19)
- Sampliner RE, "Updated guidelines for the diagnosis, surveillance, and therapy of Barrett’s esophagus", Am J Gastroenterol, 97, pp.1888~1895 (2002)
- Makuuchi H, "Endoscopic mucosal resection for early esophageal cancer. Indications and techniques", Dig Endosc, 8, pp.175~179 (1996)
- Oyama T, "Endoscopic submucosal dissection of early esophageal cancer", Clin Gastroenterol Hepatol, 3, pp.67S~70S (2005)
- Fujishiro M, "Endoscopic submucosal dissection of esophageal squamous cell neoplasms", Clin Gastroenterol Hepatol, 4, pp.688~694 (2006)
- Daly JM, "Esophageal cancer: results of an American college of surgeons patient care evaluation study", J Am Coll Surg, 190, pp.562~572 (2000)
- Guillem PG, "How to make a Barrett esophagus: pathophysiology of columnar metaplasia of the esophagus", Dig Dis Sci, 50, pp.415~424 (2005)
- Nandurkar S, "Short segment barrett's oesophagus: prevalence, diagnosis and associations", Gut, 40, pp.710~715 (1997)
- Spechler SJ, "Short and ultrashort Barrett's esophagus - what does it mean?", Semin Gastrointest Dis, 8, pp.59~67 (1997)
- Gopal DV, "Risk factors for dysplasia in patients with Barrett’s esophagus (BE): results from a multicenter consortium", Dig Dis Sci, 48, pp.1537~1541 (2003)
- Lagergren J, "Symptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma", N Engl J Med, 340, pp.825~831 (1999)
- Gottfried MR, "Incomplete intestinal metaplasia in the diagnosis of columnar lined esophagus (Barrett’s esophagus)", Am J Clin Pathol, 92, pp.741~746 (1989)
- Souza RF, "Concepts in the prevention of adenocarcinoma of the distal esophagus and proximal stomach", CA Cancer J Clin, 55, pp.334~351 (2005)
- Shaheen N, "Gastroesophageal reflux, barrett esophagus, and esophageal cancer: scientific review", JAMA, 287, pp.1972~1981 (2002)
- Enzinger PC, "Esophageal cancer", N Engl J Med, 349, pp.2241~2252 (2003)
- Seol SY, "Endoscopic diagnosis of early esophageal cancer", Korean J Gastrointest Endosc, 31, pp.3S~12S (2005)
- Pech O, "Curative endoscopic therapy in patients with early esophageal squamous-cell carcinoma or high-grade intraepithelial neoplasia", Endoscopy, 39, pp.30~35 (2007)
- Esaki M, "Risk factors for local recurrence of superficial esophageal cancer after treatment by endoscopic mucosal resection", Endoscopy, 39, pp.41~45 (2007)
- Yoshinaga S, "Clinical impact of endoscopic submucosal dissection for superficial adenocarcinoma located at the esophagogastric junction", Gastrointest Endosc, 67, pp.202~209 (2008)
- Kakushima N, "Efficacy and safety of endoscopic submucosal dissection for tumors of the esophagogastric junction", Endoscopy, 38, pp.170~174 (2006)