竹内 和男¹, 桑山 美知子², 辻 裕之³, 原 茂子³

Kazuo TAKEUCHI¹, Michiko KUWAYAMA², Hiroshi TSUJI³, Shigeko HARA³

¹虎の門病院消化器科, ²虎の門病院臨床生理検査室, ³虎の門病院健康管理センター

¹Division of Gastroenterology, Toranomon Hospital, ²Division of Clinical Physiology, Toranomon Hospital, ³Division of Health Management Center, Toranomon Hospital

キーワード : abdominal ultrasound screening test, comprehensive medical checkup, malignant tumor, sonographer

虎の門病院健康管理センター人間ドックでは，1984年開設後，毎年10,000件を超える腹部エコースクリーニング検査を行なってきた．本稿では，人間ドックで得られる各種所見について，その内容と頻度について述べるとともに，開設後5年間にエコーにより発見された悪性腫瘍の成績を示した．悪性腫瘍の頻度は全体で0.12％であり，腎臓癌が0.08％と最も頻度が高く，浸潤性膵管癌や胆管癌の頻度は0.01％以下と低かった．今後は，単に発見された悪性腫瘍の数や頻度にとどまるのではなく，早期の悪性腫瘍をどれだけ発見出来たかが問われる時代になると考えられる．そのためには，スクリーニングを担当する超音波検査士の診断能力の向上だけでなく，超音波専門医による適切な事後管理に加え，人間ドック後に引き続き行われる精密検査の質を高める必要がある．

The Toranomon Hospital Health Management Center has been carrying out more than 10,000 abdominal ultrasound screening tests a year as part of its routine comprehensive medical checkups ever since it was established in 1984. We describe the types and frequencies of an array of findings obtained from these comprehensive medical checkups and present data on malignant tumors detected on ultrasound examination during our first 5 years of operation. The overall frequency of malignant tumors was 0.12%, and renal cancer was the most common (0.08%) type of tumor encountered. Invasive pancreatic ductal carcinoma and bile duct carcinoma were rarely observed (≤0.01%). We recognize the importance of focusing on the ability of ultrasound to detect such tumors at an early stage as well as of following the number and frequency of tumors detected. This will require both improving levels of diagnostic skill of sonographers in order to ensure appropriate management by ultrasound specialists after screening, and enhancing the quality of detailed examinations conducted after comprehensive medical checkups.