Stomach and Intestine(Tokyo) Volume 42, Issue 5 (April 2007)

Magnifying Endoscopic Diagonosis for Laterally Spreading Tumor in the Colorectum Kohei Kuroda 1 , Hiro-o Yamano 1 , Kentaro Sato 1 , Kenjiro Yoshikawa 1 , Masahito Nomoto 1 , Minoru Fujita 1 , Tosihisa Hosoya 1 1Division of Gastroenterology, Akita Red Cross Hospital, Akita, Japan Keyword: 早期大腸癌 , laterally spreading tumor , pit pattern , EMR pp.801-806
Published Date 2007/4/26
  • Abstract
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 From the viewpoint of therapeutic strategies, it is important to diagnose laterally spreading tumors(LST)based on their clinicopathological characteristics. We have proposed that LSTs should be classified into two types according to their morphology, the "granular type(LST-G)" or "non-granular type(LST-NG)". Each type has two sub-groups. The former has the "homogenous type(LST-G-H)" and the "nodular mixed type(LST-G-M)". The latter has "flat type(LST-NG-F)" and the "pseudo-depressed type(LST-NG-PD)".

 LST-G-M and NG-PD are higher than the other two types in rates of early carcinomas and submucosal invasive carcinomas. Therefore, it is important to classify LSTs according to morphological type. Also, LSTs which exhibit type IIIL and IV pit patterns should be treated endoscopically, because they are considered to be free of submucosal invasive carcinomas. On the other hand, LSTs which display VN pit patterns should not be treated endoscopically, because they are often submucosally invasive. The problem is that LSTs, which have type VI pit patterns, have a wide variety of pathological features. Therefore, we must carefully choose therapeutic strategies for their treatment.

Copyright © 2007, Igaku-Shoin Ltd. All rights reserved.


42巻5号 (2007年4月)
電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院