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。

Stomach and Intestine(Tokyo) Volume 36, Issue 11 （October 2001）

胃と腸 36巻11号（2001年10月発行）

Japanese English

今月の主題 sm massive以深に浸潤した10mm以下の大腸癌

主題

sm massive以深に浸潤した10mm以下の大腸癌の分子病理学的特徴 Molecular Pathological Analysis of Colorectal Carcinomas with Massive Submucosal Invasion and Advanced Carcinomas 藤井茂彦 ^1,2 , 藤盛孝博 ¹ , 西正孝 ¹ , 甲斐原司 ¹ , 日下利広 ^1,3 , 安藤正夫 ³ , 堀公行 ⁴ , 佐野寧 ⁵ , 藤井隆広 ⁶ , 千葉勉 ² , 長廻紘 ⁷ , 加藤洋 ⁸ Shigehiko Fujii ^1,2 , Takahiro Fujimori ¹ , Masataka Nishi ¹ , Tsukasa Kaihara ¹ , Tsutomu Chiba ² ¹獨協医科大学病理学(人体分子) ²京都大学消化器病態学 ³JR仙台病院消化器内視鏡センター ⁴堀胃腸科外科 ⁵国立がんセンター東病院内視鏡部 ⁶国立がんセンター中央病院内視鏡部 ⁷群馬県立がんセンター ⁸癌研究会癌研究所病理部 ¹Department of Surgical and Molecular Pathology, Dokkyo University School of Medicine ²Division of Gastroenterology and Hepatology, Departmnent of Internal Medicine, Kyoto University, Post-graduate School of Medicine キーワード：大腸sm massive癌 , 大腸mp癌 , non-protruded type , K-ras , p53 , 接着因子 Keyword: 大腸sm massive癌 , 大腸mp癌 , non-protruded type , K-ras , p53 , 接着因子 pp.1363-1370

発行日 2001年10月25日 Published Date 2001/10/25

DOI https://doi.org/10.11477/mf.1403103339

PDF(5318KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

要旨　内視鏡的，外科的に切除された大腸sm massive癌70症例とmp癌51症例について，腫瘍径から10mm以下，11mm以上20mm以下，21mm以上の3群に分類し，増殖様式，adenoma componentの有無，K-ras変異の有無，p53，β-catenin，E-cadherinの免疫組織学的発現パターンについて解析し，10mm以下のsm massive以深に浸潤した大腸癌の分子病理学的特徴を検討した．腫瘍径10mm以下のsm massive癌とmp癌は，ともにnon-protruded typeの増殖様式を示す病変が多く，adenoma componentを伴う頻度は低かった．また，K-ras変異は低頻度であり，β-catenin，E-cadherinの細胞膜への局在が消失した病変を多く認め，21mm以上の病変とは異なった特性を示した．よって10mm以下のsm massive癌は水平方向への進展より垂直方向に浸潤する性質を持ち10mm前後の進行癌になると思われた．

　To clarify the molecular biological characteristics of early colorectal carcinomas massively invading the sub-mucosa (sm) and advanced colorectal carcinomas, we classified 70 cases of massively invading sm carcinomas and 51 cases of carcinomas with invasion of the muscularis propria (mp) into three groups according to tumor diameter as follows: － tumor less than 10 mm, more than 11 mm and less than 20 mm and more than 21 mm in diameter. We also investigated the growth type and K-ras point mutation and made an immunohistochemical study of p53, β-catenin and E-cadherin of those carcinomas.

　The rate of non-polypoid growth type of massive sm carcinomas less than 10 mm in diameter is higher than that of massive sm carcinomas more than 21 mm in diameter (70.8％ vs 7.1％; p＜0.01). Similarly, the rate of non polypoid growth type of mp carcinomas less than 10 mm in diameter is higher than that of mp carcinomas more than 21 mm in diameter (50.0％ vs 8.3％; p＜0.05). The rate of massive sm carcinomas less than 10 mm with an adenoma component is lower than that of massive sm carcinomas more than 21 mm with an adenoma component (12.5％ vs 57.1％; p＜0.05).

　The rate of K-ras mutation of massive sm carcinomas less than 10 mm in diameter is lower than that of massive sm carcinomas more than 21 mm in diameter (11.1％ vs 55.6％; p＜0.05). None of the mp carcinomas less than 10 mm in diameter showed K-ras mutation. In immunoreactivity of p53 protein, massive sm carcinomas less than 10 mm diameter showed stronger overexpression than massive sm carcinomas more than 21 mm in diameter. In immunoreactivity of E-cadherin and β-catenin, most massive sm carcinomas less than 10 mm in diameter showed decreased membranous expression. Small mp carcinomas showed similar immunoreactivity of p53, E-cadherin and β-catenin.

　Massive sm carcinomas less than 10 mm in diameter and mp carcinomas less than 10 mm in diameter showed similar molecular biological characteristics. These results suggested that sm massive carcinomas less than 10 mm in diameter develop and become small mp carcinomas.