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Diagnostic Accuracy of the Submucosal Invasion Depth for Colorectal Submucosal Cancers, Diagnosis of Submucosal Invasion Depth 1,000μm by Conventional Colonoscopy Yusuke Saitoh 1 1Third Department of Internal Medicine, Asahikawa Medical College Keyword: 大腸sm癌 , sm浸潤距離 , 通常内視鏡所見 pp.1350-1356
Published Date 2004/9/25
DOI https://doi.org/10.11477/mf.1403100566
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 A new criterion for curative endoscopic treatment of submucosal cancer was proposed by the committee of “Project Study for the Treatment of Colorectal Submucosal Cancers” in the Japanese Research Society for Cancer of the Colon and Rectum. The criterion is whether or not “the lesion is of less than 1,000μm submucosal invasion depth without vessel permeation”. Focusing on this new criterion, we retrospectively reviewed 290 lesions of submucosal cancer as to whether the conventional colonoscopic findings using indigocarmine dye spray are sufficiently predictive for 1,000μmof the submucosal invasion depth. In the 156 lesions of polypoid type submucosal cancers, the presence of surface depression, expansion appearance and normal mucosa of the tumor border (in Is type) appeared with significantly high frequency among submucosal cancers with 1,000μmor more submucosal invasion depth and the accuracy rate of prediction of invasion depth was 62.3% in Ip and Isp type, and 80.5% in Is type. In 134 lesions of flat type submucosal cancer (IIa, nodule aggregating lesions), expansion appearance and folds converging toward the tumor appeared with significantly high frequency in submucosal cancers with 1,000μmor more submucosal invasion depth and the accuracy rate of prediction of invasion depth was 76.9%. In depressed type submucosal cancers (IIc and IIa+IIc), the presence of expansion appearance, deep surface depression and irregular surface depression appeared significantly highly in submucosal cancers with 1,000μmor more submucosal invasion depth and the accuracy rate of prediction of invasion depth was 84.1%. Thus, using only coventional colonoscopy, the diagnostic accuracy for the differentiation of 1,000μmsubmucosal invasion depth was unsatisfactory. It will need to be reinforced with either another diagnostic modality or with a new way of predictive deduction from conventional colonoscopic findings in order to make the precise diagnosis of 1,000μmsubmucosal invasion depth.

 1) Third Department of Internal Medicine, Asahikawa Medical College, Asahikawa, 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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