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Indication for Endoscopic Resection of Submucosal Colo-rectal Cancer, with Special Reference to the Grade of Invasion of the Submucosa Akimichi Imamura 1 , Sei Kurokawa 1 , Toshihiro Sato 2 , Shunji Muraoka 2 1Division of Gastroenterology, Sapporo Kosei Hospital 2Division of Pathology, Sapporo Kosei Hospital Keyword: 大腸sm癌 , 深達度細分類 , 内視鏡治療 pp.765-768
Published Date 1999/5/25
DOI https://doi.org/10.11477/mf.1403103062
  • Abstract
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 A simple and convenient classification can be made by dividing the grade of invasion of the submucosa (sm) of colo-rectal cancer into three levels, i.e., sm1 ; limited within one third from the muscularis mucosae, sm2 ; limited within two thirds from the muscularis mucosae, sm3 ; invading beyond sm2. However, there are some problems with the above classification. The major one is that there are no statistical differences between sm1 and sm2 cancer in lymph node metastasis rate. Resolving the problem, we evaluated histopathologically 29 lesions of sm1 cancers which were surgically or endoscopically resected from 1990 to June 1998.

 As a result, it was noted that lymph node metastasis, lymphatic vessel invasion or tumor budding at the part ahead of the cancer front were found in well-differentiated sm1 cancers limited within 500μm from the muscularis mucosae. Therefore, we have been dividing the grade of sm1 into sm1s (shallow) -limited within 500μm from the muscularis mucosae and sm1d (deep) -advancing over 500μm.

 From a view point of grade of colo-rectal sm cancer, well-differentiated sm1s, cancer can be treated appropriately by endoscopic resection alone.


Copyright © 1999, 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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