Development and Progression of Colorectal Cancer Studied by Growth Pattern Analysis of Submucosal Invasive Cancers(PG and NPG) Masahiro Ikegami 1 , Jimi Mitobe 1 , Yujin Koike 1 , Shoichi Saitou 2 , Yoshiro Tamegai 3 1The Division of Diagnostic Pathology, The Jikei University School of Medicine, Tokyo 2The Department of Endoscopy, The Jikei University School of Medicine, Tokyo 3The Department of Gastroenterology, International Medical Center of Japan, Tokyo Keyword: 大腸SM癌 , 表面型癌 , 陥凹型癌 , 発育進展 pp.1947-1955
Published Date 2008/12/25
DOI https://doi.org/10.11477/mf.1403101539
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 Development and progression of colorectal cancers were studied by examining growth patterns in resected submucosal invasive cancers. These pathological lesions were classified into two types, polypoid growth type(PG)and nonpolypoid growth type(NPG), based on cross sectional views.

 NPG type cancers tended to show massive submucosal invasion, even when extremely small, compared to PG type cancers. NPG type cancers were found to originate from intramucosal superficial type cancer(IIc, IIc+IIa and IIa gross type)through the study of intramucosal lesions associated with submucosal invasive cancers.

 Submucosal invasive NPG type cancers tended to change their macroscopic features Is to IIa+IIc shape with the progression of submucosal invasion. Most of the advanced cancers smaller than 20mm in diameter were NPG type cancers. In contrast, the ratio of PG type to NPG type cancers, which had invaded deeply into the submucosal layer(SM2, SM3)was equal. However, NPG type cancers(12.9mm) were extremely smaller than PG type cancers(22.5mm in size).

 In conclusion, the main origin of development for advanced cancers of less than 20mm in diameter was suggested to be from superficial type cancers.

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