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Clinicopathological Study of Colorectal Carcinoid Tumor, Focusing on the Indication for Endoscopic Mucosal Resection (EMR) Ichiro Hirata 1 , Hiroshi Akutagawa 2 , Takashi Nishikawa 1 , Shingo Yasumoto 1 , Norihiro Hamamoto 1 1Department of Internal Medicine II, Osaka Medical College 2Department of Pathology I, Osaka Medical College Keyword: 大腸カルチノイド , 直腸カルチノイド , 治療方針 , 転移性大腸カルチノイド , 予後 pp.182-193
Published Date 2005/2/25
DOI https://doi.org/10.11477/mf.1403100201
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 We clinicopathologically investigated 48 cases (49 lesions) with colorectal carcinoid tumor focusing on risk factors of metastasis and evaluated the prognosis of the cases followed up after treatment.

 Concerning the relationship between tumor size and metastatic ratio, no metastasis was recognized in lesions less than 10 mm in diameter, but lymphnode and liver metastatic ratios were 40.0 % and 22.2 %, respectively, in lesions over 10 mm in diameter.

 Concerning the relationship between the depth of tumor invasion and metastatic ratio, no metastasis was recognized in lesions whose invasion was limited within the submucosal layer, but lymphnode and liver metastatic ratio were 66.7 % in lesions invading beyond the submucosal layer.

 Depression on the surface of the lesion was detected in 50 % of the lesions with metastasis, but in only 8.5 % of the lesions without metastasis.

 Vessel invasion was recognized in 100 % of the lesions with metastasis, but in only 18.6 % of the lesions without metastasis.

 The Ki-67 positive ratio (over 10 positive tumor cells/10 HPF) was recognized in 100 % of the lesions with metastasis, but in only 18.5 % of the lesions without metastasis.

 32 cases were followed up for 37.8±22.2 months. No case showed local recurrence, but metastasis and death due to the original lesion followed in all except two cases who had metastasis but died due to the originals colorectal carcinoid.

 Hence, on principle, the treatment for colorectal carcinoid tumor should be, EMR or local resection applied to carcinoid tumors less than 10 mm in diameter with invasion confined to the submucosal layer and with no vessel invasion. However, radical resection is recommended for other carcinoid tumors.


Copyright © 2005, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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