Studies on Is Type Colon Cancer with Submucosal Invasion, Radiologic Characteristics of the Sessile Colonic sm Cancer (Is, Ⅱa, Ⅱa+Ⅱc types). Gen Iinuma 1 , Kyosuke Ushio 1 1Department of Diagnostic Radiology, National Cancer Center Central Hospital Keyword: 大腸sm癌 , X線像 , 無茎性隆起 , Is型 pp.1423-1436
Published Date 1997/10/25
DOI https://doi.org/10.11477/mf.1403105219
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 For the purpose of evaluating radiologic characteristics of the sessile colonic sm cancer (Is, Ⅱa, Ⅱa+Ⅱc types), the radiologic pictures and histopathological findings of 214 lesions of colonic sm cancer were analyzed. There were 195 protruding lesions (91.1%) that were classified into 4 types (type I through type Ⅳ) by the protrusion classification of Yamada et al and were subdivided by the surface shape into the lobular type (L type) and nodular type (N type). These lesions were analyzed using the classification of the polypoid growth (PG) type and non-polypoid growth (NPG) type. Almost half of all lesions were protruding type Ⅱ lesions (105 lesions, 49.1%) and 62% of which was the N type. The proportion of the N type in the protruding type Ⅱ was higher than those in the protruding type Ⅲ (31%) and type Ⅳ (24%). In the protruding type Ⅱ, 35% of the L type had sm1 and 12.5% had sm3 invasion, whereas none of the N type had sm1 and 56.3% had sm3 invasion. Incidences of lymphatic invasion, venuos invasion and lymph gland metastasis were higher in the N type than the L type as follows: (L type, N type respectively) lymphatic invasion (17.5%, 26.2%), venous invasion (12.5%, 21.5%) and lymph gland metastasis (6.7%, 20.4%). In the protruding type Ⅱ, incidence of NPG type was 55%, which was higher than those in the protruding type Ⅲ and Ⅳ, especially when the protruding type Ⅱ lesions were subdivided into the types N and L, 72% of the type N was the NPG type. The protruding type Ⅱ lesions with nodular surface by the radiologic examination were invasive cancer deeper than the sm2 and likely to have lymphatic and venous invasion and lymph node metastasis, therefore we should be careful to make treatment plans for these lesions. Classification of the lobular and nodular shapes would help to find NPG type lesions by the radiologic examination, which were regarded as superficial type origin.

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