口腔扁平上皮癌におけるインテグリンαvファミリー発現の臨床病理学的意義

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Ꮫ఩ㄽᩥ

ཱྀ⭍ᡥᖹୖ⓶⒴࡟࠾ࡅࡿ࢖ࣥࢸࢢࣜࣥȘYࣇ࢓࣑࣮ࣜⓎ⌧

ࡢ⮫ᗋ⑓⌮Ꮫⓗព⩏

Ꮫ఩⏦ㄳ⪅ Ḉ஭⦾

㸦་ṑ⸆ಖ೺Ꮫ◊✲⛉ ་ṑ⸆Ꮫ㸧ᑓᨷ

㸦୺௵㸸ᒸᮏဴ἞ᩍᤵ㸧

ᖺ

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ㅰ㎡ ᮏ◊✲࡟㝿ࡋ㸪ᚚ᠓⠜࡞ࡿᚚᣦᑟ࡞ࡽࡧ࡟ᚚᰯ㜀ࢆ㈷ࡾࡲࡋࡓᗈᓥ኱Ꮫ኱Ꮫ 㝔་ṑ⸆ಖ೺Ꮫ◊✲㝔ᛂ⏝⏕࿨⛉Ꮫ㒊㛛ศᏊཱྀ⭍་Ꮫ࣭㢡㢦㠃እ⛉Ꮫ㸦ཱྀ⭍እ ⛉Ꮫ➨୍㸧 ᒸᮏဴ἞ᩍᤵ࡟῝ཌ࡞ࡿㅰពࢆ⾲ࡋࡲࡍ㸬ࡲࡓ㸪ᮏㄽᩥసᡂୖ㸪 ᚚᩍ♧㸪ᚚᰯ㜀ࢆ㈷ࡾࡲࡋࡓ኱Ꮫ㝔་ṑ⸆ಖ೺Ꮫ◊✲㝔ᛂ⏝⏕࿨⛉Ꮫ㒊㛛ṑ࿘ ⑓ែᏛ ᰩཎⱥぢᩍᤵ࡞ࡽࡧ࡟኱Ꮫ㝔་ṑ⸆ಖ೺Ꮫ◊✲㝔⤫ྜ೺ᗣ⛉Ꮫ㒊㛛ᑠ ඣṑ⛉Ꮫ 㤶すඞஅᩍᤵ࡟῝ㅰ⮴ࡋࡲࡍ㸬 ᑦ㸪ᮏ◊✲ࢆ㐍ࡵࡿ࡟㝿ࡋ㸪⤊ጞᚚ᠓ษ࡞ࡿᚚᣦᑟ࡜ᚚ㓄៖ࢆ㈷ࡾࡲࡋࡓᗈᓥ ኱Ꮫ⑓㝔㢡ཱྀ࣭⭍እ⛉ ᯘᇽᏳ㈗ㅮᖌ࡟ᚰ࠿ࡽឤㅰࡢពࢆ⾲ࡋࡲࡍ㸬ࡉࡽ࡟㸪 ከ኱࡞ࡿᚚᨭ᥼㸪ᚚ༠ຊࢆ㡬ࡁࡲࡋࡓᮏᏛศᏊཱྀ⭍་Ꮫ࣭㢡㢦㠃እ⛉Ꮫ㸦ཱྀ⭍ እ⛉Ꮫ➨୍㸧ᩍᐊဨࡢྛ఩࡟ឤㅰ⮴ࡋࡲࡍ㸬ࡲࡓ㸪ᮏ◊✲࡟㝿ࡋ㸪ᚚ༠ຊ㡬ࡁ ࡲࡋࡓᗈᓥ኱Ꮫ་Ꮫ㒊௜ᒓື≀ᐇ㦂᪋タ㛵ಀ⪅ྛ఩࡟࠾♩⏦ࡋୖࡆࡲࡍ㸬

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┠ḟ ➨㸯❶ ⥴ㄽ ➨㸰❶ ᑐ㇟࡜᪉ἲ ᑐ㇟ᝈ⪅ ච␿⤌⧊ᰁⰍ ⤫ィᏛⓗゎᯒ ➨㸱❶ ⤖ᯝ ྛ⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜⏕Ꮡ⋡࡜ࡢ㛵㐃 ࢖ࣥࢸࢢࣜࣥ ȘY ࣇ࢓࣑࣮ࣜⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜ࡢ┦㛵 ࢖ࣥࢸࢢࣜࣥ ȘY Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࢖ࣥࢸࢢࣜࣥ ș Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࢖ࣥࢸࢢࣜࣥ ș Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࢖ࣥࢸࢢࣜࣥ ș Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ )RFDO$GKHVLRQ.LQDVH)$.Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜ࡢ┦㛵 )RFDO$GKHVLRQ.LQDVH)$.Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࣜࣥ㓟໬ )$.S)$.Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ➨㸲❶ ⪃ᐹ ➨㸳❶ ⥲ᣓ ཧ⪃ᩥ⊩ ᅗ⾲

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➨㸯❶ ⥴ゝ ࡀࢇࡢᾐ₶࣭㌿⛣ࡣ㸪ࡀࢇ⣽⬊⮬㌟ࡢ≉ᛶࡢࡳ࡞ࡽࡎ㸪࿘ᅖࡢ㛫㉁⣽⬊ࡸ㛫㉁ᡂศ࡞࡝㸪ᐟ୺࡜ࡢ┦஫స⏝࡟ࡼࡗ࡚ࡶไᚚࡉࢀ࡚࠸ࡿ࡜⪃࠼ࡽࢀ࡚࠸ࡿ 㸬㛫㉁ᡂศࡢ୺࡞ᵓᡂ⺮ⓑ࡛࠶ࡿ⣽⬊እᇶ㉁⺮ⓑࡣ㸪⤌⧊ࡸჾᐁࡢᵓ⠏ࢆ ⥔ᣢࡍࡿᶵ⬟ࡔࡅ࡛ࡣ࡞ࡃ㸪ᡂ㛗ᅉᏊࡸࢧ࢖ࢺ࢝࢖ࣥ࡞࡝ࡢᾮᛶᅉᏊ࡜ྠᵝ࡟㸪 ⣽⬊⭷ୖ࡟Ꮡᅾࡍࡿ࢖ࣥࢸࢢࣜࣥ࡜⤖ྜࡍࡿࡇ࡜࡟ࡼࡾ㸪ከᵝ࡞⏕≀άᛶࢆ♧ ࡋ㸪ࡀࢇ⣽⬊ࡢቑṪ㸪⺮ⓑศゎ㓝⣲⏘⏕㸪⣽⬊᥋╔ࡸ㐠ືࡢㄪ⠇ᅉᏊ࡜ࡋ࡚㸪 ࡀࢇࡢᾐ₶࣭㌿⛣࡟࠾࠸࡚ࡶ㔜せ࡞ᙺ๭ࢆᢸࡗ࡚࠸ࡿࡇ࡜ࡀ▱ࡽࢀ࡚࠸ࡿ 㸬 ࢖ࣥࢸࢢࣜࣥࡣ㸪Ș 㙐࡜ ș 㙐࠿ࡽ࡞ࡿ࣊ࢸࣟ஧㔞యࡢ⭷㈏㏻ᆺࡢ⣽⬊⭷⺮ⓑ ㉁࡛㸪ࡇࢀࡲ࡛࡟ ✀㢮ࡢ Ș 㙐࡜ ✀㢮ࡢ ș 㙐ࡀሗ࿌ࡉࢀ㸪 ✀㢮ࡢ࣊ࢸࣟ ஧㔞యࢆᙧᡂࡍࡿࡇ࡜ࡀ▱ࡽࢀ࡚࠸ࡿ㸬࢖ࣥࢸࢢࣜࣥࡣ⣽⬊እᇶ㉁⺮ⓑ ࡢཷᐜయ࡜ࡋ࡚㸪⣽⬊እࢻ࣓࢖ࣥࡀ⣽⬊እᇶ㉁⺮ⓑ࡜⤖ྜࡋ㸪⣽⬊ෆࢻ࣓࢖ࣥ ࡣࢸ࣮ࣜࣥ㸪Ș࢔ࢡࢳࢽࣥࡸ࢔ࢡࢳࣥࣇ࢕࣓ࣛࣥࢺ࡞࡝✀ࠎࡢ⣽⬊㦵᱁⺮ⓑ࡜ ⤖ྜࡋ࡚࠸ࡿ㸬ࡉࡽ࡟㸪࢖ࣥࢸࢢࣜࣥࡣ⣽⬊እᇶ㉁⺮ⓑ࡜ࡢ⤖ྜ࡟ࡼࡾ㸪 ș 㙐ࡢ⣽⬊ෆࢻ࣓࢖ࣥ࡟⤖ྜࡋࡓIRFDODGKHVLRQNLQDVH)$.ࢆάᛶ໬ࡋ㸪 ᵝࠎ࡞ࢩࢢࢼࣝࢆఏ㐩ࡍࡿࡇ࡜ࡀ▱ࡽࢀ࡚࠸ࡿ㸬ࡇࡢࡼ࠺࡟㸪࢖ࣥࢸࢢ ࣜࣥࡣ⣽⬊࡜⣽⬊እᇶ㉁⺮ⓑ࡜ࡢ᥋╔ศᏊ࡜ࡋ࡚ᶵ⬟ࡋ࡚࠸ࡿࡔࡅ࡛ࡣ࡞ࡃ㸪 ⣽⬊ࡢᙧែࡸ㐠ື㸪ࡉࡽ࡟ቑṪࡸศ໬࡞࡝ࡢࢩࢢࢼࣝఏ㐩ࢆㄪ⠇ࡋ㸪ჾᐁⓎ⏕ ࡸ⤌⧊ศ໬࡟࠾࠸࡚ࡶ㔜せ࡞ᙺ๭ࢆᢸࡗ࡚࠸ࡿ㸬 ᝏᛶ⭘⒆࡟࠾࠸࡚㸪ᵝࠎ࡞࢖ࣥࢸࢢࣜࣥศᏊࡢⓎ⌧ࡀ㸪ࡑࡢᾐ₶࣭㌿⛣ࡸண ᚋ࡜┦㛵ࡍࡿࡇ࡜ࡀሗ࿌ࡉࢀ࡚࠸ࡿ㸬୰࡛ࡶ࢖ࣥࢸࢢࣜࣥ ȘY ࣇ ࢓࣑࣮ࣜࡣ㸪ᝏᛶ⭘⒆ࡢቑṪࡸ㐍ᒎ࡜ᐦ᥋࡟㛵㐃ࡋ࡚࠸ࡿࡇ࡜ࡀ▱ࡽࢀ࡚࠸ࡿ 㸬ⴭ⪅ࡢᡤᒓ◊✲ᐊࡢඛ⾜◊✲࡟࠾࠸࡚㸪࢖ࣥࢸࢢࣜࣥ ȘY 㧗Ⓨ⌧ཱྀ⭍

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ᡥᖹୖ⓶⒴⣽⬊ࡢቑṪཬࡧᾐ₶⬟ࡣ㸪㹇ᆺࢥ࣮ࣛࢤࣥ࡟ࡼࡾಁ㐍ࡉࢀࡿࡇ࡜ࡀ ሗ࿌ࡉࢀ࡚࠸ࡿ㸬 ࡑࡇ࡛ᮏ◊✲࡛ࡣ㸪࢖ࣥࢸࢢࣜࣥ ȘY ࡜ ȘY ࡢ࢝࢘ࣥࢱ࣮ࣃ࣮ࢺ࡛࠶ࡿ ș㸪 ș㸪ș㸪ș ཬࡧ ș ࡢⓎ⌧࡜㸪ཱྀ⭍ᡥᖹୖ⓶⒴ࡢ㐍ᒎࡸணᚋ࡜ࡢ㛵ಀࢆ᫂ࡽ ࠿࡟ࡍࡿࡓࡵ㸪ᗈᓥ኱Ꮫ⑓㝔㢡ཱྀ࣭⭍እ⛉࡟࡚እ⛉ⓗฎ⨨ࢆ୰ᚰ࡟ຍ⒪ࡋࡓཱྀ ⭍ᡥᖹୖ⓶⒴ࡢヨ㦂ษ㝖⤌⧊࡟࠾ࡅࡿ㸪࢖ࣥࢸࢢࣜࣥ ȘY ࡜ ș㸪ș㸪ș㸪ș ཬࡧ ș ࡢⓎ⌧ࢆච␿⤌⧊Ꮫⓗ࡟᳨⣴ࡋ㸪⮫ᗋ⑓⌮ᏛⓗᅉᏊ㸪710 ศ㢮㸪6WDJH ศ㢮ཬࡧ⏕Ꮡ⋡࡜ࡢ㛵㐃ᛶ࡟ࡘ࠸࡚ゎᯒࡋࡓ㸬ࡉࡽ࡟㸪࢖ࣥࢸࢢࣜࣥࢆ௓ࡍࡿ ࢩࢢࢼࣝఏ㐩࡟㛵୚ࡋ㸪ᝏᛶ⭘⒆ࡢቑṪࡸணᚋ࡟ᐦ᥋࡟㛵㐃ࡋ࡚࠸ࡿ IRFDO DGKHVLRQNLQDVH㸦)$.㸧ࡢ㸪ཱྀ⭍ᡥᖹୖ⓶⒴⤌⧊࡟࠾ࡅࡿⓎ⌧ࡶච␿⤌⧊Ꮫⓗ ࡟᳨ウࡋ㸪ࡑࡢⓎ⌧࡜㸪⮫ᗋ⑓⌮ᏛⓗᅉᏊཬࡧணᚋ࡜ࡢ㛵㐃ࢆゎᯒࡋࡓ㸬

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➨㸰❶ ᑐ㇟࡜᪉ἲ 㸯㸬ᑐ㇟ᝈ⪅ ᖺ ᭶࠿ࡽ ᖺ ᭶ࡲ࡛ࡢ㛫࡟㸪ᗈᓥ኱Ꮫ⑓㝔㢡ཱྀ࣭⭍እ⛉࡟࡚እ⛉ ⓗฎ⨨ࢆ୰ᚰ࡟ຍ⒪ࡋࡓཱྀ⭍ᡥᖹୖ⓶⒴ ౛ࡢ࠺ࡕ㸪ヨ㦂ษ㝖ᶆᮏ࡟ᑐࡋ࡚ ච␿⤌⧊Ꮫⓗ᳨ウࡀྍ⬟࡛࠶ࡗࡓ ౛ࢆᑐ㇟࡜ࡋࡓ㸬 ච␿⤌⧊ᰁⰍ ࣐࣍ࣝࣜࣥᅛᐃࣃࣛࣇ࢕ࣥໟᇙᶆᮏࡼࡾ ȣPࡢษ∦ࢆస〇ࡋ㸪࢟ࢩࣞࣥ ཬࡧ࢚ࢱࣀ࣮ࣝ࡟࡚⬺ࣃࣛࣇ࢕ࣥࢆ⾜ࡗࡓᚋ㸪ᢠཎࡢ㈿ά໬ࡢࡓࡵ㸪S+ࡢ P0 ࢡ࢚ࣥ㓟ᾮࡲࡓࡣ S+ ࡢ P0('7$ ࢆ⏝࠸࡚㸪Υ࡛ ศ㛫ฎ⌮ᚋ㸪 ᐊ ࣭㐽ගୗ㸪㸣㐣㓟໬Ỉ⣲ῧຍ࣓ࢱࣀ࣮࡛ࣝ ศ㛫ฎ⌮ࡋ㸪ෆᅉᛶ࣌ࣝ ࢜࢟ࢩࢲ࣮ࢮࢆࣈࣟࢵࢡࡋࡓ㸬⥆࠸࡚㸪3%6 ࡛Ὑίࡋ㸪%6$ ࡛ࣈࣟࢵ࢟ࣥ ࢢᚋ㸪 ḟᢠయ㸦⾲㸧࡛ᐊ 㸪ศ㛫㸪཯ᛂࡉࡏࡓ㸬࡞࠾㸪 ḟᢠయ࡜ࡋ࡚ᢠ ȘY ᢠయ㸪ᢠș ᢠయ㸪ᢠș ᢠయཬࡧᢠș ᢠయࢆ౑⏝ࡍࡿ㝿࡟ࡣษ∦ࢆࢡ࢚ ࣥ㓟࡛ฎ⌮ࡋ㸪ᢠ )$. ᢠయ࡛ࡣ ('7$ ฎ⌮࡟࡚㸪ᢠཎࡢ㈿ά໬ࢆ⾜ࡗࡓ㸬஧ḟᢠ య࡜ࡋ࡚㸪'DNR♫ࡢ (Q9LVLRQNLW ࡢ +53 ᶆ㆑ࢹ࢟ࢫࢺࣛࣥ⤖ྜᢠ࢘ࢧࢠ ,J* ᢠయࢆ⏝࠸࡚ᐊ ୗ ศ㛫཯ᛂࡉࡏࡓ㸬ࡑࡢᚋ㸪GLDPLQREHQ]LGLQH'$%࡟࡚ ⓎⰍࢆ⾜࡞࠸㸪࣐࣊ࢺ࢟ࢩࣜࣥ࡟࡚᰾ᰁⰍᚋ⬺Ỉ㏱ᚭ㸪ᑒධࡋ᳨㙾ࡋࡓ㸬 ᰁⰍホ౯ࡣ㸪ᰁⰍᙉᗘ࡟ࡼࡾ㸪ձ඲ࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢ㸪ղᙅᰁⰍ㸪ճ ᙉᰁⰍࡢ୕⩌࡟ࢃࡅ㸪඲ࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢࢆ㝜ᛶ㸪ᙅᰁⰍ࡜ᙉᰁⰍࢆ㝧 ᛶ࡜ุᐃࡍࡿࡇ࡜࡛⾜ࡗࡓ㸬

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Ѹ⤫ィᏛⓗゎᯒ ࢖ࣥࢸࢢࣜࣥȘYࣇ࢓࣑࣮ࣜ㸪)$.ࡲࡓࡣS)$.Ⓨ⌧࡜㸪ྛ⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜ ࡢ┦㛵ࡣ㸪Ȯ_{᳨ᐃࡲࡓࡣ࣐࣭ࣥ࣍࢖ࢵࢺࢽ࣮ࡢ8᳨ᐃ࡛ゎᯒࡋࡓ㸬⏕Ꮡ᭤⥺ࡢ⟬} ฟࡣ.DSODQ0HLHUἲ࡛⾜࠸࢖ࣥࢸࢢࣜࣥȘYࣇ࢓࣑࣮ࣜ㸪)$.ࡲࡓࡣS)$.ࡢ㝜 ᛶ⩌࡜㝧ᛶ⩌㛫ࡢ⏕Ꮡ⋡ࡢ᭷ពᕪࡣ㸪ORJUDQN᳨ᐃࢆ⏝࠸ࡓ㸬࠸ࡎࢀࡶ༴㝤⋡ ௨ୗࢆ᭷ពᕪ࠶ࡾ࡜ุᐃࡋࡓ㸬ࡍ࡭࡚ࡢ⤫ィゎᯒ࡟ࡣ㸪5ཬࡧ5ࢥ࣐ࣥࢲ࣮ࡢᶵ ⬟ࢆᣑᙇࡋࡓ⤫ィࢯࣇࢺ࢙࢘࢔࡛࠶ࡿ(=5ࢆ౑⏝ࡋࡓ㸬

(8)

➨㸱❶ ⤖ᯝ ྛ⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜⏕Ꮡ⋡࡜ࡢ㛵㐃 ᑐ㇟⑕౛ ౛୰㸪⏨ᛶ ྡ㸪ዪᛶ ྡ࡛ᖹᆒᖺ㱋ࡣ ᡯ࡛࠶ࡗࡓ㸬Ⓨ⑕ 㒊఩ู࡛ࡣ㸪ཱྀᗏ⒴ ౛㸪ୖ㢡ṑ⫗⒴ ౛㸪ୗ㢡ṑ⫗⒴ ౛㸪㢋⢓⭷⒴ ౛㸪 ⯉⒴ ౛࡛㸪⤌⧊ศ໬ᗘู࡛ࡣ㸪㧗ศ໬ ౛㸪୰➼ᗘศ໬ ౛㸪పศ໬ ౛ ࡛࠶ࡗࡓ㸬7 ศ㢮ู࡛ࡣ㸪7 ࡀ ౛㸪7 ࡀ ౛㸪7 ࡀ ౛㸪7 ࡀ ౛࡛࠶ ࡾ㸪1 ศ㢮ู࡛ࡣ㸪1 ࡀ ౛㸪1 ࡀ ౛㸪1 ࡀ ౛㸪1 ⑕౛ࡣ ⑕౛࡛㸪 ౛࡟㢕㒊ࣜࣥࣃ⠇㌿⛣ࡀࡳࡽࢀࡓ㸬࡞࠾㸪 ⑕౛ࡍ࡭࡚ 0 ࡛࠶ࡗࡓ㸬6WDJH ศ㢮࡛ࡣ㸪6WDJHϨࡀ ྡ㸪6WDJHϩࡀ ྡ㸪6WDJHϪࡀ ྡ㸪6WDJHϫࡀ ྡ࡛࠶ࡗࡓ㸦⾲㸧㸬 7ཬࡧ7ࢆྜࢃࡏࡓ౛ࡢᖺ⏕Ꮡ⋡ࡣ㸣࡛࠶ࡗࡓࡀ㸪7ཬࡧ7౛ࡢ ᖺ⏕Ꮡ⋡ࡣ࡜㸪7ཬࡧ7⩌ࡢ⏕Ꮡ⋡࡟ᑐࡋ᭷ព࡟పୗࡋ࡚࠸ࡓ㸦ᅗ㸯㸧㸬 ࣜࣥࣃ⠇㠀㌿⛣⩌ ౛ࡢ ᖺ⏕Ꮡ⋡ࡣ 㸣࡛࠶ࡗࡓࡢ࡟ᑐࡋ㸪ࣜࣥࣃ⠇ ㌿⛣⩌ ౛࡛ࡣ 㸣࡜᭷ព࡟పୗࡋ࡚࠸ࡓ㸦ᅗ 㸧㸬 6WDJH ศ㢮࡜⏕Ꮡ⋡࡜ࡢ㛵㐃ᛶࢆ᳨ウࡋࡓ⤖ᯝ㸪6WDJHϨཬࡧ 6WDJHϩ ౛ࡢ ᖺ⏕Ꮡ⋡ࡣ 㸣࡛࠶ࡗࡓࡀ㸪6WDJHϪཬࡧϫ ౛ࡢ ᖺ⏕Ꮡ⋡ࡣ 㸣 ࡜ప್ࢆ♧ࡋ஧⩌㛫࡟᭷ព࡞ᕪࡀㄆࡵࡽࢀࡓ㸦ᅗ 㸧㸬 ᡥᖹୖ⓶⒴ࡢ⤌⧊ศ໬ᗘ࡜⏕Ꮡ⋡ࡢ㛵㐃࡟࠾࠸࡚ࡣ㸪పศ໬㸪୰➼ᗘศ໬ཬ ࡧ㧗ᗘศ໬㛫ࡢࡑࢀࡒࢀࡢ⏕Ꮡ⋡࡟ࡣ⤫ィᏛⓗ࡟᭷ព࡞ᕪࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ 㸦ᅗ 㸧㸬ࡲࡓᛶᕪ㸪ᖺ㱋ཬࡧⓎ⑕㒊఩ูࡢ⏕Ꮡ⋡࡟࠾࠸࡚ࡶ㸪⤫ィᏛⓗ࡟᭷ព ᕪࡣᏑᅾࡋ࡞࠿ࡗࡓ㸦⾲㸧㸬

(9)

࢖ࣥࢸࢢࣜࣥ ȘY ࣇ࢓࣑࣮ࣜⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜ࡢ┦㛵 ࢖ࣥࢸࢢࣜࣥ ȘY Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ཱྀ⭍ᡥᖹୖ⓶⒴࡟࠾ࡅࡿ࢖ࣥࢸࢢࣜࣥȘYȘYࡢⓎ⌧ࢆච␿⤌⧊Ꮫⓗ࡟᳨ウ ࡋࡓ⤖ᯝ㸪ཱྀ⭍ᡥᖹୖ⓶⒴⣽⬊ࡢ⣽⬊⭷࡜⣽⬊㉁࡟࢖ࣥࢸࢢࣜࣥȘY ࡢⓎ⌧ࡀㄆ ࡵࡽࢀࡓ㸦ᅗ 㸧 ȘY ࡣ ⑕౛୰ ⑕౛࡟Ⓨ⌧ࡀㄆࡵࡽࢀࡓ㸬ȘY 㝜ᛶ⩌ ౛࡜㝧ᛶ⩌ ౛ ࡢ⏕Ꮡ⋡ࢆ .DSODQ0HLHU ἲ࡛ゎᯒࡋࡓ⤖ᯝ㸪㝜ᛶ⩌࡜㝧ᛶ⩌ࡢ ᖺ⏕Ꮡ⋡ࡣ㸪 ࡑࢀࡒࢀ 㸣࡜ 㸣࡛㸪ȘY 㝧ᛶ⩌ࡢ⏕Ꮡ⋡ࡣ㝜ᛶ⩌ࡢࡑࢀ࡟ẚ࡭࡚పୗ ࡋ࡚࠸ࡓࡀS ್ࡣ ࡜஧⩌㛫ࡢ⏕Ꮡ⋡࡟⤫ィᏛⓗ࡟ࡣ᭷ពᕪࡣㄆࡵࡽࢀ࡞ ࠿ࡗࡓ㸦ᅗ 㸧㸬ȘY Ⓨ⌧࡜㸪ࡑࢀࡒࢀ 7 ศ㢮㸪1 ศ㢮㸪ཬࡧ 6WDJH ศ㢮࡜ࡢ㛫 ࡢ┦㛵ࢆ᳨ウࡋࡓࡀ㸪࠸ࡎࢀ࡜ࡶ┦㛵ࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ㸬ࡲࡓ㸪ȘY Ⓨ⌧࡜ᛶ ู㸪ᖺ㱋㸪Ⓨ⑕㒊఩㸪ཬࡧ⤌⧊ศ໬ᗘ࡜ࡶ┦㛵ࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ㸦⾲㸧㸬 ࢖ࣥࢸࢢࣜࣥ ș Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࢖ࣥࢸࢢࣜࣥ șșࡣ㸪ཱྀ⭍ᡥᖹୖ⓶⒴⣽⬊ࡢ⣽⬊⭷࡜⣽⬊㉁࡟Ⓨ⌧ࡀㄆ ࡵࡽࢀࡓ㸦ᅗ 㸧 ș ࡣ ⑕౛୰ ⑕౛࡟Ⓨ⌧ࡀㄆࡵࡽࢀࡓ㸬ș 㝜ᛶ⩌ ౛ཬࡧ㝧ᛶ⩌ ౛ࡢ ᖺ⏕Ꮡ⋡ࡣࡑࢀࡒࢀ 㸣ཬࡧ 㸣࡛㸪ș 㝧ᛶ⩌ࡣ㝜ᛶ⩌࡟ẚ࡭࡚ ணᚋ୙Ⰻࡢഴྥࢆ♧ࡋࡓࡀ㸪S ್ࡣ ࡛⤫ィᏛⓗ࡟᭷ព࡞ᕪࡣࡳࡽࢀ࡞࠿ ࡗࡓ㸦ᅗ 㸧㸬ࡉࡽ࡟㸪ș Ⓨ⌧࡜㸪7 ศ㢮㸪1 ศ㢮ࡲࡓࡣ 6WDJH ศ㢮ࡢ࠸ࡎࢀ ࡜ࡶ㸪┦㛵ᛶࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ㸦⾲㸧㸬

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࢖ࣥࢸࢢࣜࣥ ș Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࢖ࣥࢸࢢࣜࣥșșࡢཱྀ⭍ᡥᖹୖ⓶⒴࡟࠾ࡅࡿⓎ⌧ࢆච␿⤌⧊Ꮫⓗ࡟᳨ウ ࡋࡓ⤖ᯝ㸪ș ࡣ㸪ཱྀ⭍ᡥᖹୖ⓶⒴⣽⬊ࡢ⣽⬊⭷࡜⣽⬊㉁࡟Ⓨ⌧ࡋ࡚࠸ࡓ㸦ᅗ 㸧㸬 ⑕౛୰ ⑕౛࡟ș ࡢⓎ⌧ࡀㄆࡵࡽࢀࡓ㸬ș 㝜ᛶ⩌ ౛࡜㝧ᛶ⩌ ౛ࡢ ᖺ⏕Ꮡ⋡ࡣࡑࢀࡒࢀ 㸣ཬࡧ 㸣࡛㸪㝧ᛶ⩌࡛ࡣ㝜ᛶ⩌࡜ẚ㍑ࡋ࡚᭷ព ࡟⏕Ꮡ⋡ࡀపୗࡋ࡚࠸ࡓ㸦ᅗ 㸧㸬ࡋ࠿ࡋ㸪ș Ⓨ⌧࡜㸪7 ศ㢮㸪1 ศ㢮㸪ཬࡧ 6WDJH ศ㢮ࡢ࠸ࡎࢀ࡜ࡶ┦㛵ᛶࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ㸬ࡲࡓ㸪ᛶู㸪ᖺ㱋㸪Ⓨ⑕㒊 ఩ཬࡧ⤌⧊ศ໬ᗘ࡜ࡶ㛵㐃ࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ㸦⾲㸧㸬 ࢖ࣥࢸࢢࣜࣥ ș Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࢖ࣥࢸࢢࣜࣥș ࡣ㸪ཱྀ⭍ᡥᖹୖ⓶⒴⣽⬊ࡢ⣽⬊⭷࡜⣽⬊㉁࡟Ⓨ⌧ࡀㄆࡵࡽࢀ ࡓ㸦ᅗ 㸧㸬ș ࡣ ౛୰㸪㝜ᛶࡀ ౛㸪㝧ᛶࡀ ౛࡛㸪㝜ᛶ⩌࡜㝧ᛶ⩌ࡢ ᖺ⏕Ꮡ⋡ࡣ㸪ࡑࢀࡒࢀ 㸣㸪㸣࡛㸪S ್ࡣ ࡜஧⩌㛫ࡢ⏕Ꮡ⋡࡟ ⤫ィᏛⓗ࡟᭷ពᕪࡣࡳࡽࢀ࡞࠿ࡗࡓ㸦ᅗ 㸧㸬୍᪉㸪ș Ⓨ⌧࡜ 1 ศ㢮㛫࡟⤫ ィᏛⓗ࡟᭷ព࡞┦㛵ࢆㄆࡵࡓS 㸬ࡋ࠿ࡋ㸪ș Ⓨ⌧࡜㸪7 ศ㢮㸪6WDJH ศ㢮㸪ᛶู㸪ᖺ㱋㸪Ⓨ⑕㒊఩㸪⤌⧊Ꮫⓗศ໬ᗘ㛫࡟ࡣ┦㛵ᛶࡣ࡞࠿ࡗࡓ㸦⾲㸧㸬 ࡞࠾㸪࢖ࣥࢸࢢࣜࣥ ș ࡜ ș ࡣ㸪࠸ࡎࢀࡢ⑕౛࡟࠾࠸࡚ࡶᰁⰍᛶࢆ♧ࡉ࡞ ࠿ࡗࡓ㸦ࢹ࣮ࢱ㠀ᥦ♧㸧㸬 )RFDO$GKHVLRQ.LQDVH)$.Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜ࡢ┦㛵 )RFDO$GKHVLRQ.LQDVH)$.Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࢖ࣥࢸࢢࣜࣥࢆ௓ࡍࡿ 0$3 ࢟ࢼ࣮ࢮ࢝ࢫࢣ࣮ࢻ➼ࡢࢩࢢࢼࣝఏ㐩࡟㛵୚ࡋ㸪ᝏ ᛶ⭘⒆ࡢቑṪࡸணᚋ࡟ᐦ᥋࡟㛵㐃ࡋ࡚࠸ࡿࡇ࡜ࡀ▱ࡽࢀ࡚࠸ࡿ㠀ࣞࢭࣉࢱ࣮ᆺ ࢳࣟࢩࣥ࢟ࢼ࣮ࢮࡢ୍ࡘ࡛࠶ࡿ IRFDODGKHVLRQNLQDVH㸦)$.㸧ࡢཱྀ⭍ᡥᖹୖ⓶

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⒴࡛ࡢⓎ⌧ࢆ᳨ウࡋࡓ㸬)$.ࡣ㸪ཱྀ⭍ᡥᖹୖ⓶⒴⣽⬊ࡢ⣽⬊⭷࡜⣽⬊㉁࡟Ⓨ⌧ ࡀࡳࡽࢀ㸦ᅗ 㸧㸪 ⑕౛୰㸪)$. 㝜ᛶࡣ ౛㸪㝧ᛶࡣ ౛࡛㸪㝜ᛶ⩌ࡢ ᖺ⏕Ꮡ⋡ࡣ 㸣㸪㝧ᛶ⩌ࡢࡑࢀࡣ 㸣࡛㸪஧⩌㛫࡟ࡣ⤫ィᏛⓗ࡟᭷ពᕪࡣ ㄆࡵࡽࢀ࡞࠿ࡗࡓ㸦ᅗ 㸧㸬ࡉࡽ࡟ )$. Ⓨ⌧࡜㸪7 ศ㢮㸪1 ศ㢮㸪6WDJH ศ㢮㸪 ᛶู㸪ᖺ㱋㸪Ⓨ⑕㒊఩ཬࡧ⤌⧊ศ໬ᗘࡢ࠸ࡎࢀ࡜ࡶ㛵㐃ᛶࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ 㸦⾲㸧㸬 ࣜࣥ㓟໬ )$.S)$.Ⓨ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ ࢖ࣥࢸࢢࣜࣥࢆ௓ࡋ࡚⣽⬊ࡀ⣽⬊እ࣐ࢺࣜࢵࢡࢫ࡟⤖ྜࡍࡿ࡜㸪)$. ࡢ⮬ᕫࣜ ࣥ㓟໬㸦 ␒┠ࡢࢳࣟࢩࣥࡢࣜࣥ㓟໬㸧ࡀ⏕ࡌ㸪ࡇࡢ㡿ᇦ࡟ 6UFIDPLO\NLQDVHV 㸦6).㸧ࡀ⤖ྜࡍࡿࡇ࡜࡛⥆࠸࡚㸪)$. ࡢ ␒┠ࡢࢳࣟࢩࣥ௨እࡢࢳࣟࢩࣥṧ ᇶࡀࣜࣥ㓟໬ࡉࢀࡿ㸬ࡉࡽ࡟㸪S&DV6KFSD[LOOLQWHQVLQ ࡞࡝ࡢࢻࢵ࢟ ࣥࢢ⺮ⓑ㉁ࡸ࢔ࢲࣉࢱ࣮⺮ⓑ㉁ࡢࢳࣟࢩࣥࣜࣥ㓟໬ࡀ㸰ḟⓗ࡟ㄏᑟࡉࢀ㸪3,. ࠿ࡽ $NW ࡟⮳ࡿ⤒㊰ࡸ㸪*UE6RV5DV ࠿ࡽ 0$3. ࡟⮳ࡿ⤒㊰ࡀάᛶ໬ࡉࢀ㸪⣽⬊ ቑṪࡸ㐠ື⬟ࡀಁ㐍ࡉࢀࡿࡇ࡜ࡀ▱ࡽࢀ࡚࠸ࡿ㸬 ࡑࡇ࡛㸪ཱྀ⭍ᡥᖹୖ⓶⒴ࡢ㐍ᒎ࡟࠾ࡅࡿάᛶ໬ )$.㸪ࡍ࡞ࢃࡕࣜࣥ㓟໬ )$. ࡢ 㛵୚࡟ࡘ࠸࡚᫂ࡽ࠿࡟ࡍࡿࡓࡵ࡟㸪S)$. ࡢⓎ⌧࡟ࡘ࠸࡚ච␿⤌⧊Ꮫⓗ࡟᳨ウࡋ ࡓ㸬ࡑࡢ⤖ᯝ㸪S)$. ࡣ୺࡟ཱྀ⭍ᡥᖹୖ⓶⒴⣽⬊ࡢ⣽⬊㉁࡟Ⓨ⌧ࡋ࡚࠸ࡓ㸦ᅗ 㸧㸬 ⑕౛୰㸪㝜ᛶࡀ ౛㸪㝧ᛶࡀ ౛࡛㸪㝜ᛶ⩌ࡢ ᖺ⏕Ꮡ⋡ࡣ 㸣࡛࠶ ࡗࡓࡢ࡟ᑐࡋ㸪㝧ᛶ⩌ࡢࡑࢀࡣ 㸣࡛㸪S ್ࡣ ࡜⤫ィᏛⓗ࡟᭷ពᕪࢆ ㄆࡵࡓ㸦ᅗ 㸧㸬୍᪉㸪S)$. ࡜㸪7 ศ㢮㸪1 ศ㢮㸪6WDJH ศ㢮㸪ᛶู㸪ᖺ㱋㸪Ⓨ ⑕㒊఩ཬࡧ⤌⧊ศ໬ᗘࡢ࠸ࡎࢀ࡜ࡶ┦㛵ࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ㸦⾲㸧㸬

(12)

➨㸲❶ ⪃ᐹ ࢖ࣥࢸࢢࣜࣥࡣ Ș 㙐࡜ ș 㙐ࡢ㸰ࡘࡢ⭷㈏㏻ᆺࢧࣈࣘࢽࢵࢺ࠿ࡽ࡞ࡿ࣊ࢸࣟ ஧㔞యࡢ⣽⬊⭷⺮ⓑ࡛㸪⣽⬊እᇶ㉁⺮ⓑࡢཷᐜయ࡜ࡋ࡚⣽⬊እᇶ㉁࡬ࡢ⣽⬊ࡢ ᥋╔ࢆㄪ⠇ࡍࡿ࡯࠿㸪⣽⬊ࡢቑṪ㸪ศ໬ࡸ㐠ືࢆไᚚࡍࡿࢩࢢࢼࣝࡢఏ㐩ࢆ⾜ ࡗ࡚࠸ࡿࡇ࡜ࡀ▱ࡽࢀ࡚࠸ࡿ㸬ࡲࡓ㸪࢖ࣥࢸࢢࣜࣥࡣჾᐁⓎ⏕ࡸ⤌⧊ศ ໬ࡢࡳ࡞ࡽࡎ㸪ࡀࢇ໬ࡸࡀࢇ⣽⬊ࡢ㐠ືࡸ⺮ⓑศゎ㓝⣲⏘⏕ࡢㄪ⠇ᅉᏊ࡜ࡋ࡚㸪 ࡀࢇᾐ₶ࡸ㌿⛣࡟࠾࠸࡚ࡶ㔜せ࡞ᙺ๭ࢆᢸࡗ࡚࠸ࡿ㸬 ≉࡟㸪࢖ࣥࢸࢢࣜࣥ ȘY ࣇ࢓࣑࣮ࣜࡣ㸪ᝏᛶ⭘⒆ࡢቑṪࡸ㐍ᒎ࡜ᐦ᥋࡟㛵㐃 ࡋ࡚࠸ࡿࡇ࡜ࡀ▱ࡽࢀ࡚࠸ࡿ㸬ࡓ࡜࠼ࡤ㸪࢖ࣥࢸࢢࣜࣥȘYș ࡣ㸪ࡀࢇ⣽⬊ࡢ 㐠ືಁ㐍ᅉᏊ࡜ࡋ࡚స⏝ࡍࡿࡔࡅ࡛ࡣ࡞ࡃ㸪άᛶᆺ࣐ࢺࣜࢵࢡࢫ࣓ࢱࣟࣉࣟࢸ ࢔࣮ࢮ ࡢ⣽⬊⭷ୖࡢཷᐜయ࡜ࡋ࡚ࡀࢇ⣽⬊⭷ୖࡢ⺮ⓑศゎάᛶࢆไᚚࡋ࡚࠸ ࡿࡇ࡜ࡀ᫂ࡽ࠿࡟ࡉࢀ࡚࠸ࡿ㸬ⴭ⪅ࡢᡤᒓࡍࡿ◊✲ᐊࡢඛ⾜◊✲࡟࠾࠸࡚ ࡶ㸪࢖ࣥࢸࢢࣜࣥ ȘY ࡀάᛶᆺ࣐ࢺࣜࢵࢡࢫ࣓ࢱࣟࣉࣟࢸ࢔࣮ࢮ 003ࡢ⣽ ⬊⭷ୖࡢཷᐜయ࡛࠶ࡿࡇ࡜ࡸ㸪㹇ᆺࢥ࣮ࣛࢤࣥࡀ࢖ࣥࢸࢢࣜࣥ ȘY ࢆ௓ࡋཱྀ࡚ ⭍ᡥᖹୖ⓶⒴⣽⬊ࡢ )$. ࡸ 0(.(5. ࢆάᛶ໬ࡋ㸪ቑṪ⬟ࢆஹ㐍ࡉࡏ࡚࠸ࡿࡇ࡜ ࢆ᫂ࡽ࠿࡟ࡋ㸪࢖ࣥࢸࢢࣜࣥ ȘY ࡀཱྀ⭍ᡥᖹୖ⓶⒴ࡢ㐍ᒎ࡟࠾࠸࡚ࡶ㔜せ࡞ᙺ ๭ࢆᢸࡗ࡚࠸ࡿࡇ࡜ࢆ᫂ࡽ࠿࡟ࡋ࡚࠸ࡿ㸬 ᮏ◊✲࡛ࡣ㸪ᗈᓥ኱Ꮫ⑓㝔㢡ཱྀ࣭⭍እ⛉࡟࡚ຍ⒪ࡋࡓཱྀ⭍ᡥᖹୖ⓶⒴ࡢヨ㦂 ษ㝖⤌⧊࡟࠾ࡅࡿ㸪࢖ࣥࢸࢢࣜࣥ ȘY ࡜ ȘY ࡢ࢝࢘ࣥࢱ࣮ࣃ࣮ࢺ࡛࠶ࡿ࢖ࣥࢸ ࢢࣜࣥ ș㸪ș㸪ș㸪ș ཬࡧ ș ࡢⓎ⌧ࢆච␿⤌⧊Ꮫⓗ࡟᳨ウࡋ㸪⮫ᗋ⑓⌮ ⓗᅉᏊ㸪710 ศ㢮㸪6WDJH ศ㢮ཬࡧ⏕Ꮡ⋡࡜ࡢ㛵㐃ᛶ࡟ࡘ࠸࡚⤫ィᏛⓗ࡟ゎᯒ࣭ ᳨ウࡋࡓ㸬ࡉࡽ࡟࢖ࣥࢸࢢࣜࣥࢆ௓ࡍࡿࢩࢢࢼࣝఏ㐩࡟㛵୚ࡋ㸪ᝏᛶ⭘⒆ࡢቑ Ṫࡸணᚋ࡟ᐦ᥋࡟㛵㐃ࡋ࡚࠸ࡿ IRFDODGKHVLRQNLQDVH㸦)$.㸧ཬࡧ S)$. ࡢཱྀ⭍

(13)

ᡥᖹୖ⓶⒴⤌⧊࡟࠾ࡅࡿⓎ⌧ࡶච␿⤌⧊Ꮫⓗ࡟᳨ウࡋ㸪⮫ᗋ⑓⌮ⓗᏛᅉᏊ࡜ண ᚋ࡜ࡢ㛵㐃ࢆゎᯒࡋࡓ㸬 ࡲࡎ㸪ཱྀ⭍ᡥᖹୖ⓶⒴ࡢྛ⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜⏕Ꮡ⋡࡜ࡢ㛵ಀࢆ᳨ウࡋࡓ㸬 ௒ᅇ㸪᳨ウࡋࡓ ⑕౛࡛ࡣ㸪ᛶᕪ㸪ᖺ㱋㸪Ⓨ⑕㒊఩ཬࡧ⤌⧊ศ໬ᗘ࡜㸪⏕Ꮡ⋡ ࡜ࡢ㛫࡟ࡣ⤫ィᏛⓗ࡟┦㛵ᛶࡣㄆࡵ࡞࠿ࡗࡓ㸬⭘⒆㐍ᒎᗘホ౯࡟⏝࠸ࡽࢀ࡚࠸ ࡿ 710 ศ㢮ࡢྛᅉᏊ࡜⏕Ꮡ⋡ࡢ㛵㐃ࢆ᳨ウࡋࡓ㸬ཎⓎ⭘⒆ࡢᣑࡀࡾࢆ⾲ࡍ 7 ศ 㢮㸪ᡤᒓࣜࣥࣃ⠇㌿⛣ࢆ⾲ࡍ 1 ศ㢮ࡸ㸪7 ศ㢮㸪1 ศ㢮ཬࡧ 0 ศ㢮࠿ࡽุᐃࡉࢀ ࡿ⮫ᗋ㐍⾜ᮇศ㢮࡛࠶ࡿ 6WDJH ศ㢮࡜ࡣཱྀ⭍ᡥᖹୖ⓶⒴ࡢ⏕Ꮡ⋡ࡢ㛫࡟ࡣᙉ࠸ ṇࡢ┦㛵ᛶࡀᏑᅾࡋࡓ㸬ࡍ࡞ࢃࡕ㸪ྛศ㢮࡟࠾࠸࡚㐍ᒎᗘࡀቑࡍ࡟ࡘࢀ㸪⏕Ꮡ ⋡ࡢపୗࡀㄆࡵࡽࢀࡓ㸬 ࢖ࣥࢸࢢࣜࣥ ȘYș㸪ș㸪ș㸪ș ཬࡧș ࡢཱྀ⭍ᡥᖹୖ⓶⒴⣽⬊࡟࠾ࡅ ࡿⓎ⌧ࢆ᳨ウࡋࡓ㸬ࡑࡢ⤖ᯝ㸪࢖ࣥࢸࢢࣜࣥ ȘY㸪ș㸪ș ཬࡧ ș ࡢⓎ⌧ࢆ ㄆࡵࡓࡀ㸪࢖ࣥࢸࢢࣜࣥș ཬࡧș ࡢⓎ⌧ࡣ௒ᅇ᳨ウࡋࡓ ౛ࡢ࠸ࡎࢀ࡟ ࠾࠸࡚ࡶ᳨ฟฟ᮶࡞࠿ࡗࡓ ࢖ࣥࢸࢢࣜࣥȘY㸪ș㸪ș ཬࡧș ࡢⓎ⌧࡜㸪ᛶู㸪ᖺ㱋㸪7 ศ㢮ࡸ 6WDJH ศ㢮㸪ࡉࡽ࡟⤌⧊ศ໬ᗘ࡜ࡣ⤫ィᏛⓗ࡟┦㛵ᛶࡣㄆࡵࡽࢀ࡞࠿ࡗࡓ㸬 ࢖ࣥࢸࢢࣜࣥ ȘY ࠶ࡿ࠸ࡣ ș Ⓨ⌧㝧ᛶཱྀ⭍ᡥᖹୖ⓶⒴࡛ࡣ㸪ȘY ࠶ࡿ࠸ࡣ ș 㝜ᛶ⩌࡟ẚ࡭⏕Ꮡ⋡ࡀపୗࡋ࡚࠸ࡓࡀ㸪⤫ィᏛⓗ࡟᭷ពᕪࡀࡳࡽࢀ࡞࠿ࡗࡓ㸬 ୍᪉㸪࢖ࣥࢸࢢࣜࣥ ș 㝧ᛶࡢཱྀ⭍ᡥᖹୖ⓶⒴ࡢ⏕Ꮡ⋡ࡣ㸪㝜ᛶ⩌ࡢࡑࢀ࡟ ẚ࡭᭷ព࡟పୗࡋ࡚࠸ࡓࡇ࡜࠿ࡽ㸪࢖ࣥࢸࢢࣜࣥ ș ࡣཱྀ⭍ᡥᖹୖ⓶⒴ࡢ᭷⏝ ࡞ணᚋண ᅉᏊ࡛࠶ࡿࡇ࡜ࡀ᫂ࡽ࠿࡜࡞ࡗࡓ㸬 ࡉࡽ࡟㸪࢖ࣥࢸࢢࣜࣥ ș Ⓨ⌧ࡣ㸪ཱྀ⭍ᡥᖹୖ⓶⒴ࡢ⏕Ꮡ⋡࡜ࡣ┦㛵ᛶࢆ♧ ࡉ࡞࠿ࡗࡓࡀ㸪ș 㝧ᛶ⩌࡟࠾ࡅࡿᡤᒓࣜࣥࣃ⠇࡬ࡢ㌿⛣ࡣ㸪㝜ᛶ⩌ࡢࡑࢀ࡟ẚ ࡭᭷ព࡟㧗ࡃ㸪ཱྀ⭍ᡥᖹୖ⓶⒴ࡢࣜࣥࣃ⠇㌿⛣ண ᅉᏊ࡛࠶ࡿ࡜⪃࠼ࡽࢀࡓ㸬

(14)

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(15)

ࢀ࡞࠿ࡗࡓࡀ㸪S)$. Ⓨ⌧㝧ᛶ⑕౛ࡢ⏕Ꮡ⋡ࡣ㝜ᛶ⩌ࡢࡑࢀ࡟ẚ㍑ࡋ࡚᭷ព࡟ప ୗࡋ࡚࠸ࡓ㸬ࡋࡓࡀࡗ࡚㸪ș ࡸș ࡟ຍ࠼࡚ S)$. ࡶཱྀ⭍ᡥᖹୖ⓶⒴ࡢ㔜せ࡞ ணᚋண ᅉᏊ࡜࡞ࡾ࠺ࡿྍ⬟ᛶࡀ♧၀ࡉࢀࡓ㸬 ࡇࢀࡲ࡛ࡢ◊✲⤖ᯝࡼࡾ㸪࢖ࣥࢸࢢࣜࣥ ș ཬࡧ S)$. Ⓨ⌧㝧ᛶ⑕౛࡛ࡣ ᖺ⏕Ꮡ⋡ࡀ᭷ព࡟పୗࡋ࡚࠸ࡓࡇ࡜ࡉࡽ࡟ ș Ⓨ⌧㝧ᛶ⑕౛࡛ࡣ㢕㒊ࣜࣥࣃ ⠇㌿⛣ࡀ᭷ព࡟ୖ᪼ࡋ࡚࠸ࡓࡇ࡜࠿ࡽ㸪࢖ࣥࢸࢢࣜࣥ ș㸪ș ཬࡧ S)$. ࡀ㸪 ᢸࡀࢇ⏕య࡟࠾࠸࡚ࡶཱྀ⭍ᡥᖹୖ⓶⒴ࡢ㐍ᒎ࡟῝ࡃ㛵୚ࡋ࡚࠸ࡿࡇ࡜ࡀ᫂ࡽ࠿ ࡟࡞ࡗࡓ㸬ࡍ࡞ࢃࡕ㸪ș ཬࡧ S)$. ࡣཱྀ⭍ᡥᖹୖ⓶⒴ࡢணᚋண ᅉᏊ࡜ࡋ࡚㸪 ࡲࡓ ș ࡣᡤᒓࣜࣥࣃ⠇㌿⛣ண ᅉᏊ࡜ࡋ࡚ࡢ᭷⏝ᛶࡀ♧ࡉࢀࡓ㸬௒ᚋ㸪ࡇࢀ ࡽศᏊࢆᶆⓗ࡜ࡋࡓཱྀ⭍⒴ࡢ᪂つデ᩿ཬࡧ἞⒪ἲࡢ㛤Ⓨࡢྍ⬟ᛶࡀ⪃࠼ࡽࢀࡓ㸬

(16)

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(17)

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(19)

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⾲⾲ ୍୍ḟᢠయ ᢠཎ ᐟ୺ ᕼ㔘ಸ⋡ ㈿ά໬ D䡒 E E E E E FAK pFAK SC-6617R (Santa Cruz)

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(23)

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(24)

ᅗ ᅗ ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ 7 ศ㢮ู⏕Ꮡ᭤⥺ 7 ཬࡧ 7 ⑕౛㸪7 ཬࡧ 7 ⑕౛ࡢ஧⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧ෆࡣ ᖺ⏕ Ꮡ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P robab ilit y Tᩘ್᪩ᮇ1㐍⾜2 1 2

p = 0.00927

䠰

1&䠰2: 53⑕౛ (88.5%)

䠰

3&䠰4: 43⑕౛ (64.5%)

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(25)

ᅗ ᅗ .DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ 1 ศ㢮ู⏕Ꮡ᭤⥺ ࣜࣥࣃ⠇㌿⛣㝜ᛶ⩌ 1 ⑕౛㸪ࣜࣥࣃ⠇㌿⛣㝧ᛶ⩌ 1 ⑕౛ࡢ஧⩌࡟ศ㢮 ࡋ᳨ウࡋࡓ㸬㸦㸧ෆࡣ ᖺ⏕Ꮡ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P ro b a b ilit y N↓0᭷1 0 1

p = 0.0154

N (-)䠖 51⑕౛ (87.9%)

N (+)䠖45⑕౛ (65.2%)

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(26)

ᅗ ᅗ ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ 6WDJH ศ㢮ู⏕Ꮡ᭤⥺ 6WDJHϨཬࡧϩ ⑕౛㸪6WDJHϪཬࡧϫ ⑕౛ࡢ஧⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧 ෆࡣ ᖺ⏕Ꮡ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P robab ilit y Stage.᪩ᮇ.㐍⾜. 1 3

p=0.004

Stage I&II 䠖41⑕౛ (92.7%)

StageIII&IV䠖55⑕౛ (66.0%)

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(27)

ᅗ ᅗ ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ⤌⧊ศ໬ᗘู⏕Ꮡ᭤⥺ పศ໬ ⑕౛㸪୰➼ᗘศ໬ ⑕౛㸪㧗ศ໬ ⑕౛ࡢ୕⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧ෆࡣ ᖺ⏕Ꮡ⋡࡛㸪ྛ⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P robab ilit y ศ໬ᗘ.ᩘᏐ 1 2 3

poor:

9⑕౛ (58.3%)

moderate: 36⑕౛ (76.3%)

well: 51⑕౛ (81.9%)

poor-moderate䠖p = 0.495

poor-well: p = 0.215

moderate-well: p = 0.505

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(28)

⾲⾲ ⮫⮫ᗋ⑓⌮ᏛⓗᅉᏊ࡜ணᚋ࡜ࡢ㛵㐃 (1)

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14 0.00927

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38

3 III&IV

38

17

0.004

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(29)

200μm 100μm ᙅᣑ኱ ᙉᣑ኱

ཱྀ⭍ᡥᖹୖ⓶⒴⤌⧊䛷䛾

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ᅗ

ᅗ ᅗ ཱཱྀྀ⭍ᡥᖹୖ⓶⒴⤌⧊࡛ࡢȘY Ⓨ⌧ ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢᕥ㸪ᙅᰁⰍ୰㸪ᙉᰁⰍྑࡢ୕⩌࡟ศࡅ㸪 ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢࢆ㝜ᛶ㸪ᙅᰁⰍཬࡧᙉᰁⰍࢆ㝧ᛶ࡜ุᐃࡋࡓ㸬

(30)

ᅗ ᅗ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ࢖ࣥࢸࢢࣜࣥȘY Ⓨ⌧ู⏕Ꮡ᭤⥺ ȘY Ⓨ⌧㝜ᛶ ⑕౛࡜㝧ᛶ ⑕౛ࡢ஧⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧ෆࡣ ᖺ⏕Ꮡ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P ro ba bilit y α刈ᩘ್ 0 2

p= 0.101

Dv (-): 41⑕౛ (87.4%)

D䡒 (+): 55⑕౛ (71.1%)

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(31)

⾲⾲ ࢖࢖ࣥࢸࢢࣜࣥȘȘYY ⓎⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ (1)_㸸_㸸_FF2_᳨_᳨_ᐃ

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10 21

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䜲䞁䝔䜾䝸䞁D䡒Ⓨ⌧䛸⮫ᗋ⑓⌮ᏛⓗᅉᏊ

(32)

ᅗ ᅗ ཱྀ⭍ᡥᖹୖ⓶⒴⤌⧊࡛ࡢș Ⓨ⌧ ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢᕥ㸪ᙅᰁⰍ୰㸪ᙉᰁⰍྑࡢ୕⩌࡟ศࡅ㸪 ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢࢆ㝜ᛶ㸪ᙅᰁⰍཬࡧᙉᰁⰍࢆ㝧ᛶ࡜ุᐃࡋࡓ㸬 200μm 100μm ᙅᣑ኱ ᙉᣑ኱

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ᅗ

(33)

ᅗ ᅗ ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ࢖ࣥࢸࢢࣜࣥș Ⓨ⌧ู⏕Ꮡ᭤⥺ ș Ⓨ⌧㝜ᛶ ⑕౛࡜㝧ᛶ ⑕౛ࡢ஧⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧ෆࡣ ᖺ⏕ Ꮡ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P robab ilit y β1ᩘ್ 0 2

p = 0.0765

E (-): 64⑕౛ (83.5%)

E (+): 32⑕౛ (67.5%)

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(34)

⾲⾲ ࢖࢖ࣥࢸࢢࣜࣥșⓎⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ (1)_㸸_㸸_FF2_᳨_᳨_ᐃ

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p ್

(-) (+)

ᛶู ⏨ᛶ 34 22 ዪᛶ 30 10 0.143㻔㻝㻕 ᖺ㱋㻢㻡ᮍ‶ 29 16 㻢㻡௨ୖ 35 16 0.664㻔㻝㻕㒊఩ ཱྀᗏ 7 3 ୖṑ⫗ 13 2 ୗṑ⫗ 24 12 㢋⢓⭷ 3 1 ⯉ 17 14 0.306㻔㻝㻕 ศ໬ᗘ 㧗ศ໬ 37 14 ୰➼ᗘ 22 14 పศ໬ 5 4 0.408㻔㻝㻕 T 1 9 2 2 28 14 3 9 6 4 18 10 0.384㻔㻞㻕 N

-

36 15

+

28 17 0.515㻔㻝㻕 Stage I 8 2 II 21 10 III 9 7 IV 26 13 0.587㻔㻞㻕 ணᚋ ⏕Ꮡ 54 22 ཎ⑓Ṛ 10 10 0.0765㻔㻟㻕⾲䜲䞁䝔䜾䝸䞁EⓎ⌧䛸⮫ᗋ⑓⌮ᏛⓗᅉᏊ

(35)

ᅗ ᅗ ཱཱྀྀ⭍ᡥᖹୖ⓶⒴⤌⧊࡛ࡢș Ⓨ⌧ ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢᕥ㸪ᙅᰁⰍ୰㸪ᙉᰁⰍྑࡢ୕⩌࡟ศࡅ㸪 ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢࢆ㝜ᛶ㸪ᙅᰁⰍཬࡧᙉᰁⰍࢆ㝧ᛶ࡜ุᐃࡋࡓ

ཱྀ⭍ᡥᖹୖ⓶⒴⤌⧊䛷䛾

EⓎ⌧

ᅗ

ᙅᣑ኱ 200μm 100μm ᙉᣑ኱

(36)

ᅗ ᅗ ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ࢖ࣥࢸࢢࣜࣥș Ⓨ⌧ู⏕Ꮡ᭤⥺ ș Ⓨ⌧㝜ᛶ ⑕౛࡜㝧ᛶ ⑕౛ࡢ஧⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧ෆࡣ ᖺ ⏕Ꮡ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P robab ilit y β6ᩘ್ 0 2 p = 0.0429 E6 (-): 39⑕౛ (86.0%) E6 (+): 57⑕౛ (71.3%)

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0 ⏕Ꮡᮇ㛫䠄᭶䠅

20

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120

0

20

40

60

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100

(37)

⾲⾲ ࢖࢖ࣥࢸࢢࣜࣥșș ⓎⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ (1)_㸸_㸸_FF2_᳨_᳨_ᐃ

E

p ್

(-) (+)

-

22 29

+

17 28 0.745㻔㻝㻕 Stage I 6 4 II 9 22 III 6 10 IV 18 21 0.647㻔㻞㻕 ணᚋ ⏕Ꮡ 35 41 ཎ⑓Ṛ 4 16 0.0429㻔㻟㻕⾲䜲䞁䝔䜾䝸䞁EⓎ⌧䛸⮫ᗋ⑓⌮ᏛⓗᅉᏊ

(38)

ཱྀ⭍ᡥᖹୖ⓶⒴⤌⧊䛷䛾

EⓎ⌧

ᅗ

200μm 100μm ᙅᣑ኱ ᙉᣑ኱ ᅗ ᅗ ཱཱྀྀ⭍ᡥᖹୖ⓶⒴⤌⧊࡛ࡢș Ⓨ⌧ ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢᕥ㸪ᙅᰁⰍ୰㸪ᙉᰁⰍྑࡢ୕⩌࡟ศࡅ㸪 ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢࢆ㝜ᛶ㸪ᙅᰁⰍཬࡧᙉᰁⰍࢆ㝧ᛶ࡜ุᐃࡋࡓ㸬

(39)

ᅗ ᅗ ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ࢖ࣥࢸࢢࣜࣥș Ⓨ⌧ู⏕Ꮡ᭤⥺ ș Ⓨ⌧㝜ᛶ ⑕౛࡜㝧ᛶ⑕౛ࡢ஧⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧ෆࡣ ᖺ⏕Ꮡ ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P robab ilit y β8ᩘ್ 0 2 p = 0.378 E8 (-): 42⑕౛ (81.1%) E8 (+): 54⑕౛ (75.2%)

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120

0

20

40

60

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100

(40)

⾲⾲ ࢖࢖ࣥࢸࢢࣜࣥșș ⓎⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ (1)_㸸_㸸_FF2_᳨_᳨_ᐃ

E

p ್

(-) (+)

ᛶู ⏨ᛶ 20 36 ዪᛶ 22 18 0.0604㻔㻝㻕 ᖺ㱋㻢㻡ᮍ‶ 18 27 㻢㻡௨ୖ 24 27 0.487㻔㻝㻕㒊఩ ཱྀᗏ 2 8 ୖṑ⫗ 7 8 ୗṑ⫗ 17 19 㢋⢓⭷ 1 3 ⯉ 15 16 0.499㻔㻝㻕 ศ໬ᗘ 㧗ศ໬ 23 28 ୰➼ᗘ 14 22 పศ໬ 5 4 0.64㻔㻝㻕 T 1 7 4 2 18 24 3 6 9 4 11 17 0.286㻔㻞㻕 N

-

29 22

+

13 32 0.0107㻔㻝㻕 Stage I 6 4 II 16 15 III 5 11 IV 15 24 0.148㻔㻞㻕 ணᚋ ⏕Ꮡ 35 41 ཎ⑓Ṛ 7 13 0.378㻔㻟㻕

⾲

䜲䞁䝔䜾䝸䞁

EEⓎ⌧䛸⮫ᗋ⑓

⌮Ꮫⓗ

ᅉᏊ

(41)

ᅗ ᅗ ཱཱྀྀ⭍ᡥᖹୖ⓶⒴⤌⧊࡛ࡢ )$. Ⓨ⌧ ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢᕥ㸪ᙅᰁⰍ୰㸪ᙉᰁⰍྑࡢ୕⩌࡟ศࡅ㸪 ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢࢆ㝜ᛶ㸪ᙅᰁⰍཬࡧᙉᰁⰍࢆ㝧ᛶ࡜ุᐃࡋࡓ㸬

ཱྀ⭍ᡥᖹୖ⓶⒴⤌⧊䛷䛾

Ⓨ⌧

ᅗ

200μm 100μm ᙅᣑ኱ ᙉᣑ኱

(42)

ᅗ ᅗ ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ )$. Ⓨ⌧ู⏕Ꮡ᭤⥺ )$. Ⓨ⌧㝜ᛶ ⑕౛࡜㝧ᛶ ⑕౛ࡢ஧⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧ෆ ࡣ ᖺ⏕Ꮡ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P ro ba bilit y tFAKᩘ್ 0 2

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䠅

0 ⏕Ꮡᮇ㛫䠄᭶䠅

20

40

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100

120

0

20

40

60

80

100 p = 0.193

FAK (-) 䠖31⑕౛ (86.2%)

FAK (+)䠖65⑕౛ (74.0%)

(43)

⾲⾲ ))$. ⓎⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ (1)_㸸_㸸_FF2_᳨_᳨_ᐃ

FAK

p ್

(-) (+)

ᛶู ⏨ᛶ 17 39 ዪᛶ 14 26 0.631㻔㻝㻕 ᖺ㱋㻢㻡ᮍ‶ 13 32 㻢㻡௨ୖ 18 33 0.503㻔㻝㻕㒊఩ ཱྀᗏ 2 8 ୖṑ⫗ 6 9 ୗṑ⫗ 10 26 㢋⢓⭷ 2 2 ⯉ 11 20 0.708㻔㻝㻕 ศ໬ᗘ 㧗ศ໬ 18 33 ୰➼ᗘ 12 24 పศ໬ 1 8 0.354㻔㻝㻕 T 1 8 3 2 10 32 3 5 10 4 8 20 0.17㻔㻞㻕 N

-

21 30

+

10 35 0.0799㻔㻝㻕 Stage I 8 2 II 8 23 III 3 13 IV 12 27 0.139㻔㻞㻕 ணᚋ ⏕Ꮡ 27 49 ཎ⑓Ṛ 4 16 0.211㻔㻟㻕

⾲

Ⓨ⌧䛸⮫ᗋ⑓⌮ᏛⓗᅉᏊ

(44)

ᅗ ᅗ ཱཱྀྀ⭍ᡥᖹୖ⓶⒴⤌⧊࡛ࡢ S)$. Ⓨ⌧ ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢᕥ㸪ᙅᰁⰍ୰㸪ᙉᰁⰍྑࡢ୕⩌࡟ศࡅ㸪 ࡲࡗࡓࡃᰁⰍࡉࢀ࡞࠿ࡗࡓࡶࡢࢆ㝜ᛶ㸪ᙅᰁⰍཬࡧᙉᰁⰍࢆ㝧ᛶ࡜ุᐃࡋࡓ㸬

ཱྀ⭍ᡥᖹୖ⓶⒴⤌⧊䛷䛾

Ⓨ⌧

ᅗ

200μm 100μm 200μm 100μm g g ᙅᣑ኱ ᙉᣑ኱

(45)

ᅗ ᅗ ..DSODQ̽0HLHUἲ࡟ࡼࡿཱྀ⭍ᡥᖹୖ⓶⒴ᝈ⪅ࡢ S)$. Ⓨ⌧ู⏕Ꮡ᭤⥺ S)$. Ⓨ⌧㝜ᛶ ⑕౛࡜㝧ᛶ ⑕౛ࡢ஧⩌࡟ศ㢮ࡋ᳨ウࡋࡓ㸬㸦㸧ෆࡣ ᖺ⏕Ꮡ⋡࡛㸪஧⩌㛫ࡢẚ㍑ࡣ /RJUDQN ᳨ᐃ࡟࡚⾜ࡗࡓ㸬 0 20 40 60 80 100 120 0.0 0.2 0.4 0.6 0.8 1.0 ⏕Ꮡᮇ㛫 P ro ba bilit y p _ __

⑌⑌

ᝈ

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䠅

0 ⏕Ꮡᮇ㛫䠄᭶䠅

20

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120

0

20

40

60

80

100

p = 0.0107 pFAK (-): 39⑕౛ (91.7%) pFAK (+): 57⑕౛ (68.6%)

(46)

⾲⾲ SS)$. ⓎⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊ (1)_㸸_㸸_FF2_᳨_᳨_ᐃ

pFAK

p ್

(-) (+)

-22 29

+

17 28 0.745㻔㻝㻕 Stage I 7 3 II 11 20 III 8 8 IV 13 26 0.181㻔㻞㻕 ணᚋ ⏕Ꮡ 36 40 ཎ⑓Ṛ 3 17 0.0107㻔㻟㻕

⾲

Ⓨ⌧䛸⮫ᗋ⑓⌮ᏛⓗᅉᏊ

(47)

⾲⾲ ࢖࢖ࣥࢸࢢࣜࣥȘȘYY ࣇࣇ࢓࣑࣮ࣜ㸪㸪))$. ཬཬࡧ SS))$. ⓎⓎ⌧࡜⮫ᗋ⑓⌮ᏛⓗᅉᏊᏊ (1)_㸸_㸸_FF2_᳨_᳨_ᐃ (2) _㸸_㸸_{Mann–Whitney U ᳨ᐃ} (3) _㸸_{Logrank ᳨ᐃ}

⾲

䜲䞁䝔䜾䝸䞁

D䡒䝣䜯䝭䝸䞊ཬ䜃

Ⓨ⌧䛸⮫ᗋ⑓⌮ᏛⓗᅉᏊ

Dv p ್ E1 p ್ E6 p ್ E8 p ್ FAK p ್ pFAK p ್ (-) (+) (-) (+) (-) (+) (-) (+) (-) (+) (-) (+) ᛶู ⏨ᛶ 24 32 34 22 21 35 20 36 17 39 20 36 ዪᛶ 17 23 0.972(1) ₃₀ ₁₀ _0.143(1) ₁₈ ₂₂ _0.461(1) ₂₂ ₁₈ _0.0604(1) ₁₄ ₂₆ _0.631(1) ₁₉ ₂₁ _0.246(1) ᖺ㱋 65ᮍ‶ 19 26 29 16 21 24 18 27 13 32 15 30 65௨ୖ 22 29 0.928(1) ₃₅ ₁₆ _0.664(1) ₁₈ ₃₃ _0.258(1) ₂₄ ₂₇ _0.487(1) ₁₈ ₃₃ _0.503(1) ₂₄ ₂₇ _0.172(1) 㒊఩ ཱྀᗏ 6 4 7 3 2 8 2 8 2 8 3 7 ୖṑ⫗ 8 7 13 2 7 8 7 8 6 9 7 8 ୗṑ⫗ 13 23 24 12 20 16 17 19 10 26 11 25 㢋⢓⭷ 2 2 3 1 1 3 1 3 2 2 3 1 ⯉ 12 19 0.584(1) ₁₇ ₁₄ _0.306(1) ₉ ₂₂ _0.114(1) ₁₅ ₁₆ _0.499(1) ₁₁ ₂₀ _0.708(1) ₁₅ ₁₆ _0.293(1) ศ໬ᗘ 㧗ศ໬ 25 26 37 14 23 28 23 28 18 33 22 29 ୰➼ᗘ 11 25 22 14 11 25 14 22 12 24 15 21 పศ໬ 5 4 0.164(1) ₅ ₄ _0.408(1) ₅ ₄ _0.251(1) ₅ ₄ _0.64(1) ₁ ₈ _0.354(1) ₂ ₇ _0.493(1) T 1 4 7 9 2 7 4 7 4 8 3 7 4 2 14 28 28 14 16 26 18 24 10 32 17 25 3 10 5 9 6 3 12 6 9 5 10 8 7 4 13 15 0.175(2) ₁₈ ₁₀ _0.384(2) ₁₃ ₁₅ _0.56(2) ₁₁ ₁₇ _0.286(2) ₈ ₂₀ _0.17(2) ₇ ₂₁ _0.0672(2) N - 19 32 36 15 22 29 29 22 21 30 22 29 + 22 23 0.346(1) ₂₈ ₁₇ _0.515(1) ₁₇ ₁₈ _0.745(1) ₁₃ ₃₂ _0.0107(1) ₁₀ ₃₅ _0.0799(1) ₁₇ ₂₈ _0.745(1) Stage I 3 7 8 2 6 4 6 4 8 2 7 3 II 10 21 21 10 9 22 16 15 8 23 11 20 III 8 8 9 7 6 10 5 11 3 13 8 8 IV 20 19 0.0799(2) ₂₆ ₁₃ _0.587(2) ₁₈ ₂₁ _0.647(2) ₁₅ ₂₄ _0.148(2) ₁₂ ₂₇ _0.139(2) ₁₃ ₂₆ _0.181(2) ணᚋ ⏕Ꮡ 36 40 54 22 35 41 35 41 27 49 36 40 ཎ⑓Ṛ 5 15 0.101(3) ₁₀ ₁₀ _0.0765(3) ₄ ₁₆ _0.0429(3) ₇ ₁₃ _0.378(3) ₄ ₁₆ _0.211(3) ₃ ₁₇ _0.0107(3)

口腔扁平上皮癌におけるインテグリンαvファミリー発現の臨床病理学的意義

Ꮫ఩ㄽᩥ

ཱྀ⭍ᡥᖹୖ⓶⒴࡟࠾ࡅࡿ࢖ࣥࢸࢢࣜࣥȘYࣇ࢓࣑࣮ࣜⓎ⌧

ࡢ⮫ᗋ⑓⌮Ꮫⓗព⩏

Ꮫ఩⏦ㄳ⪅ Ḉ஭⦾

㸦་ṑ⸆ಖ೺Ꮫ◊✲⛉ ་ṑ⸆Ꮫ㸧ᑓᨷ

㸦୺௵㸸ᒸᮏဴ἞ᩍᤵ㸧

 ᖺ

ᛶู

⏨ᛶ

56

ዪᛶ

40

ᖺ㱋

65ᮍ‶

32

65௨ୖ

92

㒊఩

ཱྀᗏ

10

ୖṑ⫗

15

ୗṑ⫗

36

㢋⢓⭷

4

⯉

31

ศ໬ᗘ

㧗ศ໬

51

୰➼ᗘ

36

పศ໬

9

T

1

11

2

42

3

15

4

28

N

-

51

+

45

Stage

I

10

II

31

III

16

IV

39

ணᚋ

⏕Ꮡ

76

ཎ⑓Ṛ

20

⾲

ᑐ㇟⑕౛

౛䛾⭘⒆⫼ᬒ

p = 0.00927

䠰

1&䠰2: 53⑕౛ (88.5%)

䠰

3&䠰4: 43⑕౛ (64.5%)

⑌

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