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[Gastric cancer 605]

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Á¶±âÀ§¾Ï ³»½Ã°æ Ä¡·á ÈÄ SM invasion ¼Ò°ßÀÌ ÀÖ¾ú½À´Ï´Ù. 500um¿´½À´Ï´Ù. ȯÀÚ¿Í ÃæºÐÈ÷ »óÀÇ ÈÄ ÃßÀû°üÂûÀ» ÇÏ´Â °ÍÀ¸·Î °áÁ¤ÇÏ¿© ½Ã¼ú 2°³¿ù¿¡ ³»½Ã°æ °Ë»ç¸¦ ÇÏ¿´½À´Ï´Ù. ÃßÀû ³»½Ã°æ °Ë»ç¿¡¼­ artificial ulcer°¡ È£ÀüµÇ¾ú´Âµ¥¿ä AHS stage·Î ¹«¾ùÀ» ºÙÀÌ´Â °ÍÀÌ ÁÁÀ»±î¿ä?


ESD: Early gastric carcinoma
1. Location : body, anterior wall
2. Gross type : EGC type IIc
3. Histologic type : tubular adenocarcinoma, moderately differentiated
4. Histologic type by Lauren : intestinal
5. Size of carcinoma : (1) longest diameter, 6 mm (2) vertical diameter, 6 mm
6. Depth of invasion : invades submucosa, (depth of sm invasion : 500 §­) (pT1b)
7. Resection margin : free from carcinoma(N), safety margin : distal 12 mm, proximal 12 mm, anterior 14 mm, posterior 14 mm, deep 1,000 §­
8. Lymphatic invasion : not identified(N)
9. Venous invasion : not identified(N)
10. Perineural invasion : not identified(N)
11. Microscopic ulcer : absent
12. Histologic heterogeneity: absent

°Ë»ç¸¦ ÇØ ÁֽŠ¼±»ý´ÔÀº H1À¸·Î ºÙÀ̼̽À´Ï´Ù. ±×·¯³ª ulcer crater°¡ ´Ù ´ÝÈù »óÅÂÀ̹ǷΠS1ÀÌ ´õ ÁÁ´Ù°í »ý°¢ÇÕ´Ï´Ù. H1Àº ´ú ¾Æ¹® »óÅÂÀ̹ǷΠ±Ë¾ç¾àÀ» ´õ µå¸± °ÍÀ» °í·ÁÇÒ ¼ö ÀÖÁö¸¸, S1Àº ´Ù ¾Æ¹® »óÅ·Πº¸°í Åõ¾àÇÒ ÇÊ¿ä´Â ¾øÀ» °ÍÀÔ´Ï´Ù.

µÎ °¡Áö ´õ »ý°¢ÇÒ Á¡

1. ESD ÈÄ ÃßÀû³»½Ã°æ¿¡¼­ º¸ÀÌ´Â ¼Ò°ßµµ ÀϹÝÀûÀÎ ¼ÒÈ­¼º ±Ë¾ç¿¡ ÁØÇÏ¿© AHS ºÐ·ù¸¦ ºÙ¿©¾ß ÇÒ±î¿ä? ²À ±×·² ÇÊ¿ä´Â ¾øÁö¸¸ communicationÀ» À§ÇÏ¿© ºÙ¿©µÎ´Â °ÍÀÌ ÆíÇÒ °Í °°½À´Ï´Ù. ¿¹¸¦ µé¾î H stage¸é ¾àÀ» ´õ ¾²¸é ÁÁ°Ú´Ù´Â signÀ¸·Î »ïÀ» ¼ö ÀÖÀ¸´Ï±î¿ä.

2. ¸¸¾à ESD ÈÄ artificial ulcer¿¡¼­ H1 stage±îÁö È£ÀüµÈ »óŶó¸é ²À PPI¸¦ ´õ ½á¾ß ÇÒ±î¿ä? ÀúÀý·Î ¹ß»ýÇÑ ¼ÒÈ­¼º ±Ë¾ç¿¡ ºñÇÏ¿© ´õ Àß ¾Æ¹°±â ¶§¹®¿¡ H1 stageÀÌ°í ±× Å©±â°¡ ÀÛÀ¸¸é PPI¸¦ ¾²Áö ¾Ê¾Æµµ ÀúÀý·Î ÁÁ¾ÆÁö´Â °Í °°½À´Ï´Ù.

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