Histopathological Characteristics of the Early Gastric Cancer with IIb-Type Extension Yasuyuki Kudo 1,2 , Seiichi Hara 1,3 , Hiroshi Ogasawara 1,4 , Shinji Tsutsumi 1,4 , Harue Akasaka 1,4 , Hiroyuki Jin 1,4 , Satoko Morohashi 1 , Fuyuki Sato 1 , Tetsuro Yoshimura 2 , Shinsaku Fukuda 2 , Hiroshi Kijima 1 1Department of Pathology and Biosience, Hirosaki University School of Medicine, Hirosaki, Japan 2Department of Gastroenterology and Hematology, Hirosaki University School of Medicine, Hirosaki, Japan 3Division of Gastroenterology and Hepatology, Depertment of Internal Medicine, Toho University Oomori Medical Center, Tokyo 4Department of Surgery, Hirosaki University School of Medicine, Hirosaki, Japan Keyword: 早期胃癌 , ESD , 手つなぎ型胃癌 , 未分化混合型胃癌 , 胃型・胃優位胃腸型形質 pp.14-22
Published Date 2010/1/25
DOI https://doi.org/10.11477/mf.1403101831
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 Recent advances in imaging diagnosis, endoscopic technology and endoscopic submucosal dissection(ESD)have provided improvement in diagnosis and treatment of early gastric cancer. Based on these advances, a lot of endoscopists have focused on cases of intramucosal gastric cancer with ill-defined margins. One of the significant causes of the ill-defined cancer margins is that the cancers have absolutely flat areas, i.e. areas of IIb-type intramucosal spreading cancer. Histopathologically, the IIb-type intramucosal spreading areas are frequently composed of(a)moderately differentiated tubular adenocarcinoma in a fused-gland pattern or(b)well differentiated tubular adenocarcinoma associated with invasive poorly differentiated components. These IIb-type adenocarcinomas mainly show gastric phenotype with mucin. When gastric biopsy shows gastric-phenotype adenocarcinoma, early gastric cancer with IIb-type ill-defined margin should be listed as one of the main differential diagnoses.

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