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Japanese

Progress in Endscopic Evaluation of the Infiltration Depth of Superficial Esophageal Cancer from the Point of View of Magnifying Endoscopy Haruhiro Inoue 1 , Makoto Kaga 1 , Satoshi Sugaya 1 , Yoshitaka Sato 1 , Noriko Odaka 1 , Hitoshi Satodate 1 , Shin-ei Kudo 1 1Digestive Disease Center, Showa University Northern Yokohama Hospital Keyword: IPCL , intra-epithelial papillary capillary loop , 上皮乳頭内毛細血管ループ , 拡大内視鏡 , 深達度診断 , 微小癌 pp.197-205
Published Date 2006/2/25
DOI https://doi.org/10.11477/mf.1403100272
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 In the esophagus there seems to be no equivalent of pit pattern in the glandular epithelium as an index of structure atypism of the tissue. During magnifying endoscopic observation we pay attention to IPCL (intra-epithelial papillary capillary loop) as a marker for tissue structural atypism. It is considered that the IPCL changes relate to tissue atypism of the para-basal layer/basal layer. IPCL type classification is expected to become not only a marker of the tissue atypism but also a marker of invasion depth. IPCL type V-1 in magnifying endoscopy is diagnosed as carcinoma in situ with a tetrad of dilatation, tortuosity, caliber variation and configuration heterogeneity in IPCL. IPCL type V-2, V-3 demonstrates the breakdown of IPCL according to tumor vascularization advancement with cancer invasion. IPCL type VN is the finding characteristic of deep sm part-infiltration of the cancer. It is supposed that real cancer invasion amounts to the magnifying endoscopic findings at an equal level to it or at a deeper layer. IPCL type classification can be applied significantly to flat lesions as the endoscopic diagnosis of tissue atypism. IPCL type IV and V lesion is a good candidate for treatment by EMR/ESD. Magnifying observation has already been adopted as a part of regular endoscopic observation.


Copyright © 2006, 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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