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Japanese

Macroscopic Diagnosis of the Extension and the Depth of Cancer Invasion of Superficial Barrett's Adenocarcinoma Gen Watanabe 1 , Yoichi Ajioka 2 , Ken Nishikura 3 , Hidenobu Watanabe 1Division of Molecular and Diagnostic Pathology, Gradulate School of Medical and Dental Sciences 2Division of Molecular and Functional Pathology, Gradulate School of Medical and Dental Sciences, Niigata University 3Emeritus Professor, Niigata University Keyword: 表在Barrett食道癌 , 肉眼診断 , 癌の進展範囲 , 癌の深達度 , 二重粘膜筋板 , 粘膜内癌細分類 pp.1275-1286
Published Date 2004/8/25
DOI https://doi.org/10.11477/mf.1403100558
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 Five cases of superficial Barrett's adenocarcinoma surgically resected were examined macroscopically and histologically for the macroscopic diagnosis of their extension and the depth of cancer invasion. Intramucosal carcinoma was divided into m1; in which the carcinoma was limited to within the newly generated muscularis mucosae, and m2; in which the carcinoma extended beyond the newly generated muscularis mucosae but not beyond the proper muscularis mucosae of the esophagus. Macroscopic diagnosis of the m1 cancers was almost impossible because they were flat and showed no change in either color or surface appearance as compared to the surrounding non-neoplastic mucosa. The m2 cancers can be detected and their extension margin can be determined macroscopically because of their convexo-concave appearance, brownish color and lobular, fine villous, granular, nodular surface appearance. To determine the extension margin of the cancer, one should take into consideration the possibility that the cancer may extend widely beneath the squamous epithelium of the esophagus. Submucosal invasion of such cancers can be detected by their (1) markedly brownish color, (2) elevation, and (3) loss of transparency and of the surface appearance. They presented neither deep depression, erosion, and/or ulceration, which factors represent the destruction of the mucosal component. It is explained by the fact that their histology is papillary and/or low-grade atypia. Some m2 cancers showed a macroscopic appearance reminiscent of cancer with massive submucosal invasion. To establish a macroscopic (endoscopic) diagnosis system of the depth of cancer invasion which is essential for endoscopic treatment of Barrett's adenocarcinoma, it is considered important to elucidate whether or not such macroscopic appearance would be a general form of m2 cancers during their development and growth.

 1) Division of Molecular and Diagnostic Pathology, Gradulate School of Medical and Dental Sciences, Niigata University, Niigata, Japan

 2) Division of Molecular and Functional Pathology, Gradulate School of Medical and Dental Sciences, Niigata University, Niigata, Japan

 3) Emeritus Professor, Niigata University, Niigata, Japan


Copyright © 2004, 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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