Endoscopic Mucosal Resection of Early Gastric Carcinoma: The Possibility of Extending its Indication-being Based on Pathological Study Junko Fujisaki 1 , Masahiro Ikegami 2 , Yayoi Arai 2 , Yoko Ota 2 , Syouriki Hino 2 1Department of Endoscopy, The Jikei University School of Medicine 2Department of Pathology, The Jikei University School of Medicine Keyword: 内視鏡的胃粘膜切除術(EMR) , 早期胃癌 , sm癌 pp.1091-1100
Published Date 1996/8/25
DOI https://doi.org/10.11477/mf.1403104223
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 We examined the relationship between the degree of submucosal infiltration, lymph node metastasis and vascular invasion in resected sm carcinoma specimens of 551 cases. The degree of vertical submucosal infiltration was classified into four stages, namely, sm1a, sm1b sm2 and sm3. These findings suggested that, for deciding endoscopic therapy in sm carcinoma, the cases should be those of well differentiated adenocarcinoma of sm1a, of 30 mm or smaller without ulceration except type I early gastric carcinoma. Considerring horizontal infiltration, EMR was indicated as curative in some sm1b carcinoma cases. For deciding whether or not EMR should be carried out in sm carcinoma, the following indicators are useful: Well differentiated adenocarcinoma, Ⅱa type, degree of vertical sm invasion is 500μm, and degree of horizontal invasion is 1,500μm and Ⅱc type, degree of vertical sm invasion is 500μm, and degree of horizontal invasion is 1,500μm. These cases were no lymph node metastasis. However, these indicators are not valid if there is lymph node metastasis. Therefore, it can be said that there is a possibility that the indication for EMR can be extended to sm1 cancers where the submucosal invasion is 500μm.

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