Previous | Home | EndoTODAY | List | Next
[IIa + IIc : deeper than expectation]
2008³â 12¿ù 4ÀÏ EndoTODAY (¾ÏÈ£: smcgi)¸¦ ´Ù½Ã Àоú½À´Ï´Ù. ´Ù¼Ò ¼öÁ¤ÇÏ¿´½À´Ï´Ù (¼öÁ¤ ºÎºÐ = »¡°).
Á¶±âÀ§¾Ï º´¼Ò¿¡ ´ëÇÑ ³»½Ã°æÀýÁ¦¼úÀ» ½ÃÇàÇÏ¿© ´ÙÀ½°ú °°Àº °á°ú¸¦ ¾ò¾ú½À´Ï´Ù. "Tubular adenocarcinoma, pyloro-cardiac type, moderately differentiated, 1x0.9cm, Invades submucosa, (depth of sm invasion : 500 §) (pT1b), Resection margin: free from carcinoma (safety margin: distal 0.9 cm, proximal 0.8 cm, anterior 1 cm, posterior 2.2 cm, deep 300 §), Lymphatic invasion : not identified, Venous invasion : not identified"
¿©·¯ºÐÀº ÀÌ·± °æ¿ì °æ°ú°üÂûÀ» ÃßõÇϽôÂÁö ¼ö¼úÀ» ÃßõÇϽôÂÁö ±Ã±ÝÇÕ´Ï´Ù. Àú´Â ÀϹÝÀûÀ¸·Î °æ°ú°üÂûÀ» ÃßõÇÏ°í ÀÖ½À´Ï´Ù.
À§¾ÏÀÇ depth of invasionÀ» Æò°¡ÇÏ´Â °ÍÀº ¸Å¿ì ¾î·Á¿î ÀÏÀÔ´Ï´Ù. ÀϹÝÀûÀ¸·Î EUS°¡ À§¾ÏÀÇ ½É´Þµµ¸¦ Æò°¡Çϴµ¥ µµ¿òÀÌ µÉ °ÍÀ¸·Î ÁÖÀåµÇ°í ÀÖÀ¸³ª ½ÇÁ¦ ÀÛÀº Á¶±âÀ§¾ÏÀÇ EMR/ESD¸¦ ½ÃÇà ¿©ºÎ¸¦ °áÁ¤ÇØ¾ß ÇÏ´Â »óȲ¿¡¼ EUS°¡ ¾î´À Á¤µµ µµ¿òµÇ´ÂÁö ¸íÈ®ÇÏÁö ¾Ê½À´Ï´Ù. ¾à 30 %Á¤µµÀÇ over-staging°ú ºñ½ÁÇÑ Á¤µµÀÇ under-stagingÀÌ ÇØ°áµÇÁö ¾ÊÀº ¹®Á¦À̱⠶§¹®ÀÔ´Ï´Ù. °æÇèÀÌ ¸¹Àº ½Ã¼úÀÚµéÀÇ °æ¿ì ½É´Þµµ Áø´ÜÀÇ Á¤È®µµ°¡ ³ô°ÚÁö¸¸, ÀϹÝÀûÀ¸·Î inter-observer variationÀÌ ¸Å¿ì Å« ºÐ¾ß¶ó°í ÇÏÁö ¾ÊÀ» ¼ö ¾ø½À´Ï´Ù. °³ÀÎÀûÀ¸·Î´Â EMR/ESD ½ÃÇà Àü routineÇÏ°Ô EUS¸¦ ½ÃÇàÇÏÁö´Â ¾Ê½À´Ï´Ù.
Àú¸¸ ´À³¢°í ÀÖ´Â °ÍÀÎÁö ¸ð¸£°ÚÀ¸³ª IIa + IIc´Â Á¡¸·ÇÏ Ä§À±ÀÌ ¸¹½À´Ï´Ù. IIc º´¼ÒÀÇ ½É´Þµµ´Â »ý°¢º¸´Ù ³·Àº °æ¿ì°¡ ¸¹Áö¸¸ IIa + IIc º´¼Ò´Â ¿¹»óqº¸´Ù ½É´Þµµ°¡ ±íÀº ¿¹°¡ ¸¹½À´Ï´Ù.
[Home]