雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

検索

書誌情報 詳細検索 by 医中誌

Japanese

Limitations of Dissecting Microscopy for the Diagnosis of the Extent of the Spread of Cancer Cells-A Fundamental Study on Endoscopic Complete Resection of Gastric Carcinoma Takahiro Fujimori 1 1The Second Department of Pathology, Kobe University School of Medicine Keyword: 早期胃癌の内視鏡的切除 , 実体顕微鏡観察 , 連続切片 , 切除断端 , 癌遺残 pp.301-310
Published Date 1991/3/25
DOI https://doi.org/10.11477/mf.1403102486
  • Abstract
  • Look Inside
  • Cited by

 In the present paper, we compare and contrast the image reconstructed from serial sections and the image obtained though dissecting microscopy, as a means to diagnose the quality and spread of cancer cells. We describe the limitations of the latter method (AHmethod).

1. Qualitative diagnosis.

 The observations of dissecting microscopy permit a qualitative diagnosis of lesions whose maximum major diameter is 3-5 mm longer than those able to be observedly histological serial section.

2. Spreaddiagnosis.

 In order to determine the degree of discrepancy between the results of observations by dissecting microscopy and those made in histological samples we compared and contrasted the histologically reconstructed image of serial sections and the dissecting microscopic images obtained from two cases of undifferentiated carcinoma and three cases of differentiated carcinoma. In the differentiated carcinoma cases, the error betwewen the extension of carcinoma determined by dissecting microscopy and the reconstructed image of serial sections was within approximately 1 mm or less. On the other hand, however, undifferentiated carcinoma was found to have spread more extensively than was able to be estimated by dissecting microscopy;the error was 3-4 mm.

 From these findings, it was concluded that in differentiated carcinoma cases, the extension of carcinoma spread was diagnosed as being almost the same, no matter which of the two methods were used. It was thought that remnant cancer cells need not be taken into consideration as long as there is a space of more than approximately 1 mm from the cut end during dissecting microscopic observation (about the width of two to three gastric glands). In the case of undifferentiated carcinoma, on the other hand, it was suggested that cases may bediagnosed as negative by dissecting microscopy, but, in step-sections sliced parallel to the major axis of the lesion, there may be positive indications of spread.

 Because of this, the method in which tissue sections are observed under the dissecting microscopy is effective in the evaluation of differentiated carcinoma. However, for the complete resection of the carcinoma in the case of undifferentiated carcinoma, this methodology raises some problems. There is difficulty in the interpretation of the extent of the remnant of a carcinoma present in the cut end during ordinary pathological examination.


Copyright © 1991, Igaku-Shoin Ltd. All rights reserved.

基本情報

電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

関連文献

もっと見る

文献を共有