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Diagnosis of SM1 Differentiated Type Early Gastric Cancer (Penetrates into the Submucosa Less than 500μm)―Compared with SM2 Early Gastric Cancer (Penetrates into the Submucosa over 500μm) : Endoscopic Diagnosis of Depressed Type Early Gastric Cancer with Converging Folds Atsushi Mitsunaga 1 , Izumi Shirato 1 , Takayoshi Nishino 1 , Ryujiro Imai 2 , Maiko Kishino 2 , Hiroyuki Konishi 2 , Shinichi Nakamura 2 , Keiko Shiratori 2 , Itaru Ohi 3 1Department of Endoscopy, Yachiyo Medical Center, Tokyo Women's Medical University, Yachiyo, Japan 2Department of Gastroenterology, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo 3Department of Endoscopy, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo Keyword: 陥凹型早期胃癌 , 集中皺襞 , SM1癌 , SM2癌 , 平均sm厚 pp.61-68
Published Date 2007/1/25
DOI https://doi.org/10.11477/mf.1403100385
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 In comparing SM1 gastric cancer (the depth of submucosal penetration less than 500μm) with SM2 gastric cancer (the depth of submucosal penetration over 500μm) with converging folds, clubbing and fusion of the converging folds, which is often seen in SM2 gastric cancer (we already reported that the fusion of the converging folds could not be found in M gastric cancer), we were made to think that these shapes of the converging folds appear when cancer penetrates into the submucosa, especially into the deep layer of the submucosa. Furthermore the thickness of the lesion is more typical in SM2 gastric cancer compared with SM1 gastric cancer and this appearance is emphasized by decreasing air infusion. From pathological findings, this thickening is because, when gastric cancer penetrates into the submucosa over 500μm, the volume of cancer and the reactive fibrosis increases. 75% of gastric cancers with submucosal thickness over 2,000μm are SM2 gastric cancers. Because of this we are thinking that it might be possible to make a differential diagnosis of SM1 and SM2 gastric cancer by measuring the thickness of the submucosa using endoscopic ultrasonography.


Copyright © 2007, 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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