X線像による遡及的経過例からみた表面型大腸腫瘍の発育進展

Growth Pattern of Superficial Colon Tumor Determined by Retrospective Radiologic Observations

要旨　大腸癌取扱い規約のⅡa型，Ⅱb型，Ⅱc型およびそれらの複合型を示し，更に大きさが6～20mmの腫瘍性病変を，表面型腫瘍と定義した．この表面型腫瘍の発育進展につき，X線像による遡及的検討を行い，その自然史について次のような知見を得た．①表面型腫瘍の多くは，相似した形態を保ちながら，同じ型の早期癌に推移しやすい．②茎を持たない病変のうちでも，表面型腫瘍はより進行癌に推移しやすい病変である．③遺伝性非ポリポーシス大腸癌（HNPCC）で，好発する表面型腫瘍の発育進展は，通常の大腸癌への自然史と同じであろうと推定された．

　Superficial tumor is designated as tumorous lesion with the form of type Ⅱa, type Ⅱb, type Ⅱc, or combined type which is described in the management rules and regulations of colon cancer, and between 6 and 20 mm in size. We analyzed radiologic examinations of superficial tumors retrospectively for the purpose of evaluating natural history of superficial tumors and the following findings were obtained : 1) Most of superficial tumor grew similarly in shape into early cancer. 2) Among sessile lesions, superficial tumors tended to change into advanced cancers. 3) Patients with hereditary non-polyposis colorectal cancer may frequently have superficial tumors whose growth pattern seemed to be the same as that of usual colon cancer.