Histological Criterion for Complete Resection of Early Gastric Carcinoma Invading the Submucosa:A Special Reference to Submucosal Tumor Invasion and Resected Margin Masafumi Oya 1 , Takashi Yao 1 , Toshio Kouzuki 1 , Masazumi Tsuneyoshi 1 1The Second Department of Pathology, Faculty of Medicine, Kyushu University Keyword: sm胃癌 , sm細分類 , 内視鏡的治療 , 癌遺残 pp.1589-1597
Published Date 1998/11/25
DOI https://doi.org/10.11477/mf.1403103865
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 We examined 23 early gastric carcinoma cases with submucosal invasion obtained by endoscopical resection (EMR). Eight cases were followed by the additional surgical resection and, in one case, re-EMR therapy was added. In the remaing 14 cases endoscopic follow-up with biopsy examination has been applied. In three cases, residual carcinoma at the submucosal layer as well as at the mucosa was revealed in the surgical specimens. Lymph node metastasis was detected in only one case. The following histological parameters are more frequently observed in the EMR specimens among residual carcinoma cases than among non-residual cases: 1) A large lesion more than 15 mm in diameter. 2) Prominent lymphatic and/or venous invasion. 3) Deep submucosal invasion more than 500μm, beneath the muscularis mucosae. 4) Presence of a poorly-differentiated component. 5) A submucosal invasive front with electrodesiccation artifacts, less than 200μm distant from resected margin. Early gastric carcinoma lacking the above-mentioned histological risky findings could be treated by EMR.

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