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

Endoscopic Evaluation of Depth of Cancer Invasion in Cases with Superficial Esophageal Cancer Misao Yoshida 1 , Kumiko Momma 2 , Tomoko Hanashi 1 , Yosuke Izumi 1 , Nobuhiro Sakaki 3 1Department of Surgery, Tokyo Metropolitan Komagome General Hospital 2Department of Endoscopy, Tokyo Metropolitan Komagome General Hospital 3Department of Gastroenterolgy, Tokyo Metropolitan Komagome General Hospital pp.295-306
Published Date 2001/2/26
DOI https://doi.org/10.11477/mf.1403103151
  • Abstract
  • Look Inside
  • Cited by

 Endoscopic evaluation of the depth of cancer invasion in cases with superficial esophageal cancer is important in selection of treatment. Lymph node metastasis is rare among cancers confined to the lamina propria mucosae. Therefore endoscopic mucosal resection (EMR) is recommended for them as the least invasive treatment. At the same time lymph node metastasis is frequent (44%) among submucosal cancers. Esophagectomy with lymph node dissection is recommended.

 The gross classification of superficial cancer works well for differentiation of submucosal cancers from mucosal cancers, such as 92% of superficial and protruded lesions (type 0-Ⅰ) and 96% of superficial and depressed (type 0-Ⅲ) lesions have submucosal invasion, while submucosal invasion is infrequent among lesions with superficial and flat type (type 0-Ⅱ: 15%). At the same time, type 0-Ⅱb lesions remained within the mucosa, but 15% of all type 0-Ⅱa and 20% of type 0-Ⅱc lesions have submucosal invasion (15% of all type 0-Ⅱ lesions). Further evaluation of type 0-Ⅱa and Ⅱc lesions should be carried out. In cases with type 0-Ⅱa, the size of the granular changes on the lesion should be analyzed. Fine granules suggest mucosal cancer and coarse granules suggest cancer invasion into the muscularis mucosae or the submucosa. In cases with type 0-Ⅱc lesions, irregularities on the lesions suggest grade of invasion, e.g. flat or fine granular changes suggest mucosal cancer, coarse granular changes suggest invasion into the muscularis mucosae and nodular changes suggest invasion into the submucosa. Endoscopic double staining can differentiate mucosal cancer as pale a blue area with or without blue dots, spots or reticulation. Nodular changes in a type 0-Ⅱc lesion and interruption of “Tataminome-folds” suggest cancer invasion into the muscularis mucosae or the submucosa. The overall accuracy rate in endoscopic estimation of cancer invasion was 81% (93% for mucosal cancer remaining within the lamina propria mucosae,60% for invasion into the muscularis mucosae or slight invasion into the submucosa and 71% for moderate or massive invasion into the submucosa).


Copyright © 2001, 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