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1. ½Äµµ¾ÏÀÇ Áø´Ü ¹× Ä¡·á (¿ï»êÀÇ´ë Á¤ÈÆ¿ë)

Tylosis palmaris: autosomal dominant ÁúȯÀÌ°í 45¼¼¿¡±îÁö Àý¹Ý Á¤µµ ½Äµµ¾ÏÀÌ ¹ß»ýÇÔ.

Tylosis (hyperkeratosis palmaris et plantaris) is characterised by focal thickening of the skin of the hands and feet and is associated with a very high lifetime risk of developing squamous cell carcinoma of the oesophagus. This risk has been calculated to be 95 % at the age of 65 in one large family, however the frequency of the disorder in the general population is not known and is likely to be less than one in 1,000,000. Oesophageal lesions appear as small (2-5 mm), white, polyploid lesions dotted throughout the oesophagus and oral leukokeratosis has also been described. Although symptoms of oesophageal cancer can include dysphagia, odynophagia, anorexia and weight loss, there may be an absence of symptoms in early disease, highlighting the importance of endoscopic surveillance in these patients. Oesophageal cancer associated with tylosis usually presents in middle to late life (from mid-fifties onwards) and shows no earlier development than the sporadic form of the disease. Tylosis with oesophageal cancer is inherited as an autosomal dominant trait with complete penetrance of the cutaneous features, usually by 7 to 8 years of age but can present as late as puberty. Mutations in RHBDF2 located on 17q25.1 have recently been found to be causative. (Orphanet J Rare Dis 2015)

½Äµµ¾ÏÀº Á¶Á÷°Ë»ç°¡ dysplasiaµç ¾ÏÀÌµç ´«À¸·Î º¸¾Æ¼­ ¾ÆÁÖ flat ÇÏÁö ¾ÊÀ¸¸é invasionÀÌ ÁøÇàµÇ°í ÀÖ´Â °ÍÀÔ´Ï´Ù. À°¾È¼Ò°ßÀÌ ÈξÀ Áß¿äÇÕ´Ï´Ù. Á¶Á÷°Ë»ç¿¡ ¼ÓÁö ¸¶½Ã±â ¹Ù¶ø´Ï´Ù. ¼ö¼úÀ» ÇÏ¿´°í, 62mm SM cancer¿´°í LN 3/41À̾ú½À´Ï´Ù. Á¤ÈÆ¿ë ±³¼ö´Ô²²¼­´Â volume-forming mucosal lesionÀÌ ÀÖÀ¸¸é (1) Ç×»ó ¾ÏÀ¸·Î »ý°¢ÇØ¾ß ÇÏ°í, (2) deep SM invasionÀ» »ý°¢ÇØ¾ß ÇÏ°í, (3) ¸²ÇÁÀý ÀüÀ̸¦ °í·ÁÇØ¾ß ÇÑ´Ù°í °­Á¶Çϼ̽À´Ï´Ù.

¼ÒÈ­±â³»°ú¿¡¼­ ¹º°¡¸¦ ÇØ ÁÖ±â À§Çؼ­´Â flat ÇÑ »óÅ¿¡¼­ ¹ß°ßÇØ¾ß ÇÕ´Ï´Ù.


2. ¿ª·ù¼º ½ÄµµÁúȯÀÇ Áø´Ü, Ä¡·á ¹× °ü¸® (¼øõÇâ´ëÇб³ È«¼öÁø)

ÃÖ±Ù Rome IV criteria¿¡¼­´Â functional heartburn, reflux hypersensitivity¿Í NERD¸¦ ±¸ºÐÇÏ¿© ¼³¸íÇÏ°í ÀÖ½À´Ï´Ù.

½Äµµ Á¡¸·ÀÇ ¹æ¾î ±âÀç´Â º¹ÀâÇÕ´Ï´Ù. Psychological stress°¡ mast cellÀ» È°¼ºÈ­½ÃÄÑ Áõ»ó ¹ß»ý¿¡ ±â¿©ÇÕ´Ï´Ù.

Farre R. NM 2013

³»½Ã°æ Ä¡·á´Â Stretta¿Í EsophyX°¡ ÀÖ½À´Ï´Ù.


3. À§¾ÏÀÇ Áø´Ü ¹× Ä¡·á (¼º±Õ°üÀÇ´ë ÀÌÁØÇà)

2017 ¼ÒÈ­±â³»°ú ºÐ°úÀü¹®ÀÇ ¿¬¼ö±³À°


4. ¼ÒÈ­¼º ±Ë¾çÀÇ Áø´Ü ¹× Ä¡·á

Peptic ulcer bleeding (Bae SJ. Eur J Gastroenterol Hepatol 2012)°ú perforation (Bae SJ. J Epidemiol 2012)Àº ¾ÆÁ÷µµ ÈçÇÑ ÆíÀε¥ °í·É¿¡¼­ »ç¸Á·üÀÌ ³ô½À´Ï´Ù.

EJGH 2012

EJGH 2012

J Epidemiol 2012

J Epidemiol 2012

Idiopathic PUD´Â ¸¸¼ºÁúȯÀÌ ¸¹°í Àç¹ßÀÌ ÈçÇÕ´Ï´Ù (Kang JM. Scand J Gastroenterol 2012).


[FAQ]

[2016-6-16. ¾Öµ¶ÀÚ ÆíÁö]

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© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.