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EndoTODAY ³»½Ã°æ ±³½Ç


[Squamous metaplasia]

Á¤»ó À§Á¡¸·Àº ¿øÁÖ¼¼Æ÷ÀÔ´Ï´Ù. °£È¤ À§Á¡¸·ÀÌ ÆíÆò»óÇÇ·Î º¯Çϱ⵵ Çϴµ¥ À̸¦ ÆíÆò»óÇÇÈ­»ý(squamous metaplasia)¶ó°í ÇÕ´Ï´Ù. ¼±Ãµ¼ºÀÎ °æ¿ì´Â ¾ø´Â °Í °°½À´Ï´Ù. ±âÀüÀº ´ÙÀ½ µÎ °¡Áö·Î ÃßÁ¤µË´Ï´Ù. (1) ¸¸¼º¿°ÁõÀ¸·Î ÀÎÇÑ È­»ý¼ºÀ§¿°°ú ÇÔ²² ÆíÆò»óÇÇÈ­»ýÀÌ ¹ß»ýÇÑ´Ù´Â °¡¼³ÀÔ´Ï´Ù. (2) ¹Ì¶õÀ̳ª ±Ë¾çÀ¸·Î ÀÎÇÏ¿© À§Á¡¸· Å»¶ôÀÌ ¹ß»ýÇÑ ÈÄ squamous epitheliumÀÌ À§(êÖ)ÂÊÀ¸·Î creepingÇÑ´Ù´Â °¡¼³ÀÔ´Ï´Ù. À§½ÄµµÁ¢ÇպΠº´¼Ò¸¦ ESDÇÑ ÈÄ À§Á¡¸·ÀÌ ÀÖ¾î¾ß ÇÒ ºÎÀ§°¡ ÆíÆò»óÇÇ·Î ¹Ù²ï °æ¿ì°¡ ÀÖ½À´Ï´Ù. ÃÖ±Ù °æÇèÇÑ Áõ·Ê¸¦ ¼Ò°³ÇÕ´Ï´Ù. ¿ìÃø ÇÏ´Ü »çÁøÀ» º¸¸é ESD·Î ÀÎÇÑ ±Ë¾çÀÌ squamous epitheliumÀ¸·Î healingµÇ¾ú½À´Ï´Ù. (2015-2-17. ÀÌÁØÇà)

Á¤»ó À§Á¡¸·Àº ¿øÁÖ»óÇÇ(columnar epithelium)ÀÌ°í ³»½Ã°æ¿¡¼­ ºÐÈ«»öº¸´Ù Á¶±Ý ºÓ°Ô º¸ÀδÙ. Á¤»ó ½ÄµµÁ¡¸·Àº ÆíÆò»óÇÇÀÌ°í ³»½Ã°æ¿¡¼­ ÇϾé°Ô º¸ÀδÙ. µå¹°°Ô À§Á¡¸·ÀÌ ÆíÆò»óÇÇ·Î º¯Çϱ⵵ Çϴµ¥ À̸¦ ÆíÆò»óÇÇÈ­»ý(squamous metaplasia)À̶ó°í ºÎ¸¥´Ù. ±âÀüÀº ´ÙÀ½ µÎ °¡Áö·Î ÃßÁ¤µÈ´Ù. (1) ¸¸¼º¿°ÁõÀ¸·Î ÀÎÇÑ È­»ý¼ºÀ§¿°°ú ÇÔ²² ÆíÆò»óÇÇÈ­»ýÀÌ ¹ß»ýÇÑ´Ù´Â °¡¼³°ú (2) ¹Ì¶õÀ̳ª ±Ë¾çÀ¸·Î ÀÎÇÏ¿© À§Á¡¸· Å»¶ôÀÌ ¹ß»ýÇÑ ÈÄ ÆíÆò»óÇÇ°¡ À§(êÖ)ÂÊÀ¸·Î ±â¾î°¡´Â µí ÀÚ¶õ´Ù(¡°creeping¡±)´Â °¡¼³ÀÌ´Ù. º» Áõ·Ê´Â À§½ÄµµÁ¢Çպο¡ °¡±î¿î À§º´¼Ò¸¦ ³»½Ã°æÀ¸·Î ÀýÁ¦ÇÑ ÈÄ ¹ß»ýÇÑ Àΰø±Ë¾çÀÌ ÀϺδ ¿øÁÖ»óÇÇ·Î ÀϺδ ÆíÆò»óÇÇ·Î Ä¡À¯µÈ ÇüÅ¿´´Ù. Çô ¸ð¾çÀÇ ÆíÆò»óÇÇÈ­»ý ºÎÀ§°¡ ½ÄµµÀÇ ÆíÆò»óÇÇ¿Í ¿¬°áµÇ¾î ÀÖÀ¸¹Ç·Î ½Äµµ»óÇÇ°¡ ±â¾î°¡µí (¡°creeping¡±) ÀÚ¶ó Àΰø±Ë¾çÀÇ ÀϺÎÀ» ¸Þ¿î °ÍÀ¸·Î ÃßÁ¤µÈ´Ù. Hiatal hernia°¡ Àִ ȯÀÚ¿¡¼­ ºñ½ÁÇÑ ¸ð¾çÀÇ ÆíÆò»óÇÇÈ­»ý(squamous metaplasia)À» °üÂûÇϵDZ⵵ ÇÑ´Ù.

µé¹® Á÷ÇϺΠÀ§Á¡¸·¿¡ ÇÏ¾á ºÎÀ§°¡ º¸À̸é ÆíÆò»óÇÇÈ­»ýÀ» ÀǽÉÇÒ ¼ö ÀÖ°í, Lugol¾×À» ºÐ¹«ÇÏ¿© °¥»öÀ¸·Î º¯ÇÏ´Â °ÍÀ» °üÂûÇÏ¸é °ÅÀÇ Á¤È®ÇÏ´Ù°í ¸»ÇÒ ¼ö ÀÖ´Ù. ÃÖÁ¾ÀûÀÎ Áø´ÜÀº Á¶Á÷°Ë»ç °á°ú¿¡ µû¸¥´Ù. ÇϺνĵµ ÆíÆò»óÇÇ°¡ Ư¼ö¿øÁÖ»óÇÇ·Î ¹Ù²ï ¹Ù·¿½Äµµ´Â Àü¾Ï¼º º´¼Ò·Î °£ÁֵǴ ¹Ý¸é, À§Á¡¸·ÀÇ ÆíÆò»óÇÇÈ­»ý¿¡¼­ ¾ÏÀÌ ¹ß»ýÇÏ¿´´Ù´Â º¸°í´Â ¾ø´Ù.


¿À·¡ Àü¿¡ hiatal hernia¸¦ °¡Áø ȯÀÚ¿¡¼­ squamous metaplasia¸¦ ¹ß°ßÇÑ °æ¿ìµµ ÀÖ¾ú½À´Ï´Ù.

ºÎ»ê´ëÇб³ ±è±¤ÇÏ ±³¼ö´Ô²²¼­ Clinical EndoscopyÁö¿¡ º¸°íÇÑ ¹Ù ÀÖ½À´Ï´Ù (Clin Endosc 2013;46:407-409).

Clin Endosc 2013


[2014-6-20. ¾Öµ¶ÀÚ Áú¹®]

°Ç°­°ËÁø ³»½Ã°æÀÔ´Ï´Ù. EG junction ¾Æ·¡¿¡¼­ whitish abnormal lesionÀÌ ¹ß°ßµÇ¾ú°í 6°³¿ù ÈÄ¿¡µµ º° º¯È­°¡ ¾ø¾ú½À´Ï´Ù. ¾î¶»°Ô Çؼ®ÇØ¾ß ÇÒÁö ¹®Àǵ帳´Ï´Ù.

[2014-6-20. ÀÌÁØÇà ´äº¯]

À§ »óÇÇ°¡ ½Äµµ »óÇÇó·³ º¯ÇüµÈ squamous metaplasia of the gastric mucosaÀÎ °ÍÀ¸·Î »ý°¢µË´Ï´Ù. ÀÌÀ¯´Â ¾Ë ¼ö ¾øÁö¸¸ cardia ±Ùó À§ »óÇÇÀÇ ÀϺΰ¡ Å»¶ôµÈ ÈÄ ½Äµµ»óÇÇ°¡ creepingÇÏ¿© ¹ß»ýÇÑ °ÍÀ¸·Î ÃßÁ¤ÇÏ°í ÀÖ½À´Ï´Ù. Á¶Á÷°Ë»ç¸¦ ÇØ º¸¸é Á¤»ó ½Äµµ»óÇÇó·³ ³ª¿É´Ï´Ù. Ưº°ÇÑ Ä¡·á´Â ÇÊ¿äÇÏÁö ¾Ê½À´Ï´Ù.


[References]

1) EndoTODAY À§¿°

2) À§¿Í Àå 2007;42(9):1411-1416.

3) GI pathology: an atlas and text, 3rd ed.

"Morphologic, histochemical, and enzymatic patterns enable one to recognize five major types of metaplasia occurring in the stomach: intestinal, pyloric, pancreatic, ciliated, and squamous. The first three types are the most common."

4) Takeda et al. Endoscopic observation of squamous metaplasia of the stomach: a report of two cases. Endoscopy 2000;32:651-653

5) Jeon et al. A Case of Squamous Metaplasia of the Stomach. Clin Endosc 2013;46:407-409

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